Chronic Thromboembolic Pulmonary Hypertension and Chronic ThromboembolicPulmonary Disease (CTEPD): Clinical and Interventional Perspective

After an episode of acute pulmonary embolism chronic thrombotic lesions may persist at the level of the pulmonary circulation causing different clinical scenarios, from asymptomatic patients with complete functional recovery to chronic thromboembolic pulmonary hypertension. In the middle lies the concept of chronic thromboembolic pulmonary disease that identifies a subgroup of patients with persistent thrombotic lesions, symptoms on exertion, and pulmonary vascular dysfunction, but without pulmonary hypertension at rest. The exact diagnostic criteria, prevalence, natural history, and therapeutic approach are not well defined yet. We review existing evidence on chronic thromboembolic pulmonary disease, with special emphasis on its definition, epidemiology, pathophysiology, radiological characteristics, and therapeutic approach.