Review Articles

Chronic Thromboembolic Pulmonary Hypertension Medical Management



Chronic thromboembolic pulmonary hypertension (CTEPH) is a common long-term complication of pulmonary embolism characterized by thromboembolic obstruction of the pulmonary arteries, vascular arteriopathy, vascular remodeling, and ultimately pulmonary hypertension (PH). Although pulmonary endarterectomy (PEA) surgery is the standard of care, approximately 40% of patients in the international CTEPH registry were deemed inoperable. In addition to lifelong anticoagulation, the cornerstone of PH-specific medical management is riociguat, a soluble guanylate cyclase stimulator. Medical management should be started early in CTEPH patients and may be used as a bridge to PEA surgery or balloon pulmonary angiography. Medical management is indicated for inoperable CTEPH patients and patients who have recurrence of PH after PEA surgery.


CTEPHchronic thromboembolic pulmonary hypertensionriociguatpulmonary embolismpulmonary endarterectomy
  • Year: 2021
  • Volume: 17 Issue: 2
  • Page/Article: e29-e33
  • DOI: 10.14797/ICHN7633
  • Accepted on 25 Mar 2021
  • Published on 1 Jul 2021
  • Peer Reviewed