Balloon Pulmonary Angioplasty for Inoperable Chronic Thromboembolic Pulmonary Hypertension

Left untreated, chronic thromboembolic pulmonary hypertension (CTEPH) leads to right heart failure and death. Pulmonary thromboendarterectomy is the gold-standard curative treatment. However, surgery is not an option for up to 35% of CTEPH patients for a variety of reasons. For those patients, a new option is balloon pulmonary angioplasty, a catheter-based procedure well established in its application for treating blocked arteries in the heart and brain. Clinicians at the Respiratory Institute are now using this procedure in inoperable CTEPH and have observed immediate radiographic improvement in pulmonary blood flow, as well as dramatic improvements in symptoms and pulmonary pressures.

Pulmonary Embolism Response Team

In patients with acute pulmonary embolism, clinicians face the difficult task of assessing the risk of death and balancing that against the risk of bleeding to identify patients who might benefit from early reperfusion therapies, including systemic thrombolysis, catheter-directed therapies, or surgical embolectomy. At Cleveland Clinic, a multidisciplinary pulmonary embolism response team (PERT) has been assembled to provide rapid evaluation, risk stratification, and management recommendations for patients with acute pulmonary embolism. PERT members — representing pulmonary and critical care medicine, vascular medicine, interventional radiology, interventional cardiology, emergency medicine, and cardiothoracic surgery — provide this consultative service round-the-clock to ensure that patients receive appropriate therapy in an expedited fashion.