Lung Injury After Balloon Pulmonary Angioplasty for CTEPH: Histopathologic Findings and Management Implications

Pulmonary hypertension (PH) is a severe complication of Takayasu arteritis (TAK) with pulmonary artery involvement (PAI), associated with poor prognosis. Serum uric acid (UA) has been linked to both TAK severity and PH in other settings, but its role specifically in TAK-PAI-associated PH remains unclear. 

Chronic thromboembolic pulmonary hypertension (CTEPH) is a distinct subtype of pulmonary hypertension arising from persistent major pulmonary artery obstruction after pulmonary embolism.

CTEPH remains underdiagnosed and can be difficult to differentiate on routine CTPA from acute PE and from patients without pulmonary thromboembolism. We developed and evaluated a fully automated CTPA-based machine learning algorithm combining vascular blood volume metrics with clot and periclot imaging features.

Acute-on-chronic thromboembolic pulmonary hypertension (acute-on-CTEPH) is associated with rapid clinical deterioration, yet the role of invasive intervention in the acute phase remains poorly defined.