Chronic thromboembolic pulmonary hypertension (CTEPH) is a pulmonary hypertension caused by mechanical obstruction of the pulmonary arteries by organised thrombi and microvascular arteriopathy. It occurs as a complication of pulmonary embolism, and if left untreated, results in right heart failure and death. The gold standard for treatment is pulmonary endarterectomy (PEA) which removes obstructive thromboemboli surgically. For inoperable cases, balloon pulmonary angioplasty (BPA) is an alternative that uses balloon dilatation to open up the arteries. Medical therapy is reserved for cases that are not suitable for PEA, BPA, or residual pulmonary hypertension occurring post-procedures.
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