Zusammenfassung
Die chronisch thromboembolische pulmonale Hypertonie (CTEPH) ist eine mögliche Folgeerkrankung nach akuter Lungenembolie, bei welcher es infolge organisierter Emboliereste und eines pulmonalvaskulären Umbaus zu einer Erhöhung des pulmonalvaskulären Widerstands mit konsekutiver präkapillärer pulmonaler Hypertonie (PH) kommt. Die Diagnose einer CTEPH setzt eine mindestens 3-monatige therapeutische Antikoagulation und den Nachweis persistierender pulmonaler Perfusionsstörungen voraus, welche sehr sensitiv mit der Ventilations-/Perfusionsszintigrafie nachgewiesen werden können. Zur definitiven Diagnosestellung sollten die Patienten an ein Expertenzentrum überwiesen werden. Die Therapie besteht aus lebenslanger therapeutischer Antikoagulation und – je nach Lage der Verschlüsse und Ausmaß der PH – einer operativen Entfernung organisierter Embolien, einer lungengefäßerweiternden Medikation, einer Ballondilatation einzelner Stenosen/Verschlüsse oder einer Kombination dieser Maßnahmen.
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Lange, T. (2024). Chronisch thromboembolische pulmonale Hypertonie. In: Hoffmann, U., Weiss, N., Czihal, M., Mühlberg, K.S., Freisinger, E. (eds) Klinische Angiologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-61379-5_147-1
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