Adameit Miriam S D, Wiedenroth Christoph B, Omlor Albert, Schäfers Hans-Joachim, Guth Stefan, Wilkens Heinrike
Dtsch Med Wochenschr. 2023 Nov;148(23):1514-1523. doi: 10.1055/a-2012-0899. Epub 2023 Nov 10.
Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare disease, but an important late sequela after acute pulmonary embolism. Therefore, follow-up after at least three months of sufficient anticoagulation is recommended. Patients with suspected CTEPH should be referred to specialized CTEPH centers for further evaluation and treatment.Three treatment modalities are available: pulmonary endarterectomy (PEA), balloon pulmonary angioplasty (BPA) and pulmonary hypertension-targeted drugs. The indication for surgery depends mainly on the localization of the pulmonary arterial obstructions. Severe comorbidities as well as advanced age need individual evaluation, but do not present strict exclusion criteria. Multimodal treatments are common practice in inoperable CTEPH. However, treatment decision making in an experienced multidisciplinary team is mandatory.
慢性血栓栓塞性肺动脉高压(CTEPH)是一种罕见疾病,但却是急性肺栓塞后重要的晚期后遗症。因此,建议在充分抗凝至少三个月后进行随访。疑似CTEPH的患者应转诊至专门的CTEPH中心进行进一步评估和治疗。有三种治疗方式可供选择:肺动脉内膜剥脱术(PEA)、球囊肺动脉成形术(BPA)和肺动脉高压靶向药物。手术适应症主要取决于肺动脉阻塞的部位。严重合并症以及高龄需要进行个体化评估,但并非严格的排除标准。多模式治疗在无法手术的CTEPH中很常见。然而,必须由经验丰富的多学科团队做出治疗决策。