title: Prevention and treatment of the post-thrombotic syndrome and of the chronic thromboembolic pulmonary hypertension.
abstract: Post-thrombotic syndrome (PTS) and chronic thromboembolic pulmonary hypertension (CTEPH) are late complications of venous thromboembolism. The purpose of this review is to present and discuss recently published studies that have improved our knowledge of PTS and CTEPH. The current understanding of the pathophysiology of PTS and CTEPH is discussed as well as the importance of chronic residual venous thrombosis, some polymorphisms of plasminogen activator inhibitor-1, and the current concept of misguided thrombus resolution. The surprising finding that elastic compression stockings may not be effective in preventing PTS and the novel medical treatment in CTEPH are discussed in detail. Novel direct oral anticoagulants show potential for prevention of PTS. No firm conclusions can be drawn on the efficacy of elastic stockings. Novel treatments of CTEPH for inoperable patients and those with persistent pulmonary hypertension after surgery have become available and further research on wider indication for their use is urgently needed.
authors.affiliation: Department of Cardiothoracic and Vascular Sciences, Vascular Medicine Unit, University of Padua, Via Giustiniani 2, 35128 Padua, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Pesavento
authors.forename: Paolo
authors.initials: P
authors.lastname: Prandoni
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D002908:Chronic Disease; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000628:therapy*; D054070:Postthrombotic Syndrome / Q000175:diagnosis / Q000628:therapy*; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000628:therapy*; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000628:therapy*
chemical_list: D000925:Anticoagulants
keywords: chronic thromboembolic pulmonary hypertension; compression stockings; deep vein thrombosis; post-thrombotic syndrome; pulmonary embolism; pulmonary endarterectomy; stasis ulcer; venous thromboembolism