Chronic thromboembolic pulmonary hypertension (CTEPH), a rare consequence of an acute pulmonary embolism, is a disease that is underdiagnosed, and surgical pulmonary thromboendarterectomy (PTE) remains the preferred therapy. However, determination of operability is multifactorial and can be challenging. There is growing excitement for the percutaneous treatment of inoperable CTEPH with data from multiple centers around the world showing the clinical feasibility of balloon pulmonary angioplasty. Riociguat remains the only approved medical therapy for CTEPH patients deemed inoperable or with persistent pulmonary hypertension after PTE. We recommend that expert multidisciplinary CTEPH teams be developed at individual institutions. Additionally, optimal and standardized techniques for balloon pulmonary angioplasty need to be developed along with dedicated interventional equipment and appropriate training standards. In the meantime, the percutaneous revascularization option is appropriate for patients deemed inoperable in combination with targeted medical therapy, or those who have failed to benefit from surgery.

中文翻译：

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慢性血栓栓塞性肺动脉高压

慢性血栓栓塞性肺动脉高压 (CTEPH) 是急性肺栓塞的一种罕见后果，是一种诊断不足的疾病，外科肺血栓内膜切除术 (PTE) 仍然是首选治疗方法。然而，可操作性的确定是多因素的，可能具有挑战性。随着来自世界各地多个中心的数据显示球囊肺血管成形术的临床可行性，对不能手术的 CTEPH 的经皮治疗越来越令人兴奋。Riociguat 仍然是 PTE 后被认为不能手术或持续肺动脉高压的 CTEPH 患者的唯一获批药物疗法。我们建议在各个机构建立专家级多学科 CTEPH 团队。此外，需要开发球囊肺血管成形术的最佳和标准化技术以及专用的介入设备和适当的培训标准。同时，经皮血运重建方案适用于联合靶向药物治疗被认为不能手术的患者，或未能从手术中获益的患者。