In vivo characterization of changes in composition of organized thrombus in patient with chronic thromboembolic pulmonary hypertension treated with balloon pulmonary angioplasty

Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) results from obstruction or stenosis of pulmonary arteries by organized thrombi frequently, but not universally, as a complication of deep venous thrombosis (DVT) [ [1] Kantake M. Tanabe N. Sugiura T. et al. Association of deep vein thrombosis type with clinical phenotype of chronic thromboembolic pulmonary hypertension. Int. J. Cardiol. 2013; 165: 474-477 Abstract Full Text Full Text PDF PubMed Scopus (7) Google Scholar ]. Pulmonary endarterectomy (PEA) has been considered as a treatment of choice for this disease [ [2] Konstantinides S.V. Torbicki A. Agnelli G. et al. Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology. 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur. Heart J. 2014; 35: 3033-3069 Crossref PubMed Scopus (84) Google Scholar ], however a significant number of patients are disqualified from the operation due to peripheral location of thromboembolic lesions or comorbidities [ [3] Pepke-Zaba J. Delcroix M. Lang I. et al. Chronic thromboembolic pulmonary hypertension (CTEPH): results from an international prospective registry. Circulation. 2011; 124: 1973-1981 Crossref PubMed Scopus (661) Google Scholar ]. These patients have a poor prognosis, which is in proportion to the level of mean pulmonary artery pressure (mPAP) [ [4] Riedel M. Stanek V. Widimsky J. Prerovsky I. Longterm follow-up of patients with pulmonary thromboembolism. Late prognosis and evolution of hemodynamic and respiratory data. Chest. 1982; 81: 151-158 Crossref PubMed Scopus (646) Google Scholar ].