علاج مرض الانسداد الرئوي الخثاري المزمن ذي الأعراض مع عيوب التروية غير المتطابقة والجلطات الليفية، دون ارتفاع ضغط الدم الرئوي

DOI: 10.1093/eurheartj/ehac237

• Chronic thrombo-embolic pulmonary disease describes symptomatic patients with mismatched perfusion defects on V/Q scan and with signs of chronic, organized, fibrotic clots on CTPA or DSA, such as ring-like stenoses, webs/slits, and chronic total occlusions (pouch lesions or tapered lesions), after at least 3 months of therapeutic anticoagulation.
• PEA or BPA should be considered in selected symptomatic patients with CTEPD without PH.
• Selected symptomatic patients with CTEPD without PH can be successfully treated by PEA, with clinical and haemodynamic improvements at rest and exercise.
• Selected symptomatic patients with CTEPD without PH and segmental/subsegmental lesions can successfully be treated by BPA, with clinical and haemodynamic improvements at rest and exercise.