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Review
. 2023 Sep 1;29(5):340-347.
doi: 10.1097/MCP.0000000000000987. Epub 2023 Jul 17.

Updates in the diagnosis and management of chronic thromboembolic disease

Alisha Kabadi  1 , Kim Kerr, Timothy M Fernandes
Affiliations
Review

Updates in the diagnosis and management of chronic thromboembolic disease

Alisha Kabadi et al. Curr Opin Pulm Med. .

Abstract

Purpose of review: Chronic thromboembolic disease (CTED) is distinct from chronic thromboembolic pulmonary hypertension (CTEPH) and is defined by dyspnea on exertion after acute pulmonary embolism with the presence of residual perfusion defects and absence of resting pulmonary hypertension. Here, we review clinical features and diagnostic criteria for CTED and summarize treatment options.

Recent findings: The optimal management for CTED is unclear as the long-term outcomes of conservative vs. invasive treatment for this disease have not been reported. There are a few studies evaluating outcomes of pulmonary thromboendarterectomy and balloon pulmonary angioplasty (BPA) in CTED, concluding that these procedures are safe and effective in select patients. However, these trials are small nonrandomized observational studies, reporting outcomes only up to 1 year after the intervention. Conservative management of CTED with observation, pulmonary hypertension-targeted therapy, or cardiopulmonary rehabilitation has not been studied. It is unknown whether these treatments are as effective or superior to pulmonary thromboendarterectomy or BPA in CTED.

Summary: The management of CTED is individualized and based on symptoms and exercise limitations. Early referral of patients with CTED to a specialized CTEPH center is recommended to determine if watchful waiting, BPA, or pulmonary thromboendarterectomy is most beneficial.

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References

    1. Nijkeuter M, Hovens MM, Davidson Bruce, et al. Resolution of thromboemboli in patients with acute pulmonary embolism: a systematic review. Chest 2006; 129:192–197.
    1. Sanchez O, Helley D, Couchon S, et al. Perfusion defects after pulmonary embolism: risk factors and clinical significance. J Thromb Haemost 2010; 8:1248–1255.
    1. Pesavento R, Filippi L, Palla A, et al. Impact of residual pulmonary obstruction on the long-term outcome of patients with pulmonary embolism. Eur Respir J 2017; 49:1601908.
    1. Klok FA, Tijmensen JE, Haeck JLA, et al. Persistent dyspnea complaints at long-term follow-up after an episode of acute pulmonary embolism: results of a questionnaire. Eur J Intern Med 2008; 19:625–629.
    1. Nilsson LT, Andersson T, Larsen F, et al. Dyspnea after pulmonary embolism: a nation-wide population-based case–control study. Pulm Circ 2021; 11:20458940211046831.