Coronary - Chronic Thromboembolic Pulmonary Hypertension Incidence, Post-pulmonary Embolism Syndrome and Possible Role of Transcatheter Therapy in Prevention

Sep 30, 2026

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Pulmonary embolism (PE) drives both acute and chronic complications that meaningfully worsen patient outcomes. Acute events include syncope or sudden death, commonly linked to severe hypoxaemia or right ventricular failure, along with early embolism recurrence. Over time, survivors may develop post-embolic syndrome (PES), affecting more than half of patients, featuring persistent dyspnoea and reduced exercise tolerance. PES is associated with chronic thromboembolic pulmonary hypertension and disease, right ventricular dysfunction, deconditioning and psychological harm. Evidence for catheter-directed therapy preventing chronic sequelae remains unconfirmed without large randomized trials.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Review

Pulmonary embolism and epidemiology

Acute complications

Post-embolic syndrome and chronic complications

Current evidence and rationale for transcatheter therapy

Components of post-embolic syndrome

REVIEW Coronary Chronic Thromboembolic Pulmonary Hypertension Incidence, Post-pulmonary Embolism Syndrome and Possible Role of Transcatheter Therapy in Prevention Belén Biscotti Rodil ,1,2 Juan Duarte Torres ,1,2 Irene Martín De Miguel ,1,2 Alejandro Cruz Utrilla ,1,2,3 Nicolás Maneiro Melón ,1,2 Jorge Nuche Berenguer ,1,2 Yolanda Revilla Ostolaza ,4 Sergio Alonso Charterina 4 , María Jesús López Gude ,5 Carmen Jiménez López-Guarch ,1,2,3 Fernando Arribas Ynsaurriaga ,1,2,3 Pilar Escribano Subías 1,2,3 and Maite Velázquez Martín 1,2,3 1. Department of Cardiology, Hospital Universitario 12 de Octubre, Madrid, Spain; 2. Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; 3. Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; 4. Department of Radiology, Hospital Universitario 12 de Octubre, Madrid, Spain; 5. Department of Cardiac Surgery, Hospital Universitario 12 de Octubre, Madrid, Spain Abstract Pulmonary embolism (PE) presents both acute and chronic complications that significantly affect patient outcomes. Acute complications include syncope or sudden death, often resulting from severe hypoxaemia or right ventricular failure; and early recurrence of the embolicevent. Chronic complications, which can develop over time, are often grouped under post-embolic syndrome (PES), a condition affecting more than half of PE survivors. Symptoms of PES include persistent dyspnoea and reduced exercise tolerance. PES is associated with several serious conditions, such as chronic thromboembolic pulmonary hypertension, chronic thromboembolic pulmonary disease, right ventricular dysfunction, physical deconditioning, and psychological harm. Although promising catheter-directed therapies are under investigation for acute PE treatment, their effectiveness in preventing chronic complications has yet to be confirmed by large-scale randomised controlled trials. Keywords Acute pulmonary embolism, chronic thromboembolic pulmonary hypertension, post-pulmonary embolism syndrome, transcatheter therapy Received: 14 November 2024 Accepted: 16 February 2025 Citation: Interventional Cardiology 2025;20:e37. DOI: [https://doi.org/10.15420/icr.2024.50](https://doi.org/10.15420/icr.2024.50)[ ](https://doi.org/10.15420/icr.2024.50)[Disclosure:](Disclosure: IMM is supported by a National R)[ IMM is supported by a National R](Disclosure: IMM is supported by a National R)í[o](o) Hortega Grant from ISCIII (CM23/00235) and has received honoraria from Johnson & Johnson and travel support from Johnson & Johnson and MSD. ACU is supported by a National Juan Rodés Grant from ISCIII (JR23/00071) and has received consulting fees from Janssen, honoraria from AOP Orphan, Gossamer Bio, Janssen and MSD, and travel support from Gossamer Bio, Janssen and MSD. MJLG has received travel support from Gossamer Bio, Janssen and MSD. CJLG has received honoraria from Janssen, MSD, Pfizer and Ferrer, and travel support from Janssen and MSD. PES has received honoraria from AOP Health, Ferrer, Janssen, MSD and Gossamer. All other authors have no conflicts of interest to declare. Correspondence: Maite Velázquez Martín, Cardiology Department, 12 de Octubre Hospital, Avenida de Córdoba, Madrid 28041, [Spain. E: maitevel05@gmail.com](Spain. E: maitevel05@gmail.com) Copyright: © The Author(s) 2025. This work is open access and is licensed under CC-BY-NC 4.0. Users may copy, redistribute and make derivative works for non-commercial purposes, provided the original work is cited correctly. Pulmonary embolism (PE) refers to the obstruction of the pulmonary circulation caused by a preformed thrombus in the venous vascular territory. It presents with a wide variety of features. Although some of its most common presentations are non-specific, such as dyspnoea, cough, pleuritic pain, tachycardia or tachypnoea, its more severe forms can also manifest as cardiogenic shock or sudden death.1 The cu

FAQs

What acute complications are associated with pulmonary embolism?

Acute complications include syncope or sudden death, often related to severe hypoxaemia and/or right ventricular failure, as well as early recurrence of embolism.

What is post-embolic syndrome (PES) and what symptoms does it cause?

PES is a chronic condition developing after an embolic event, defined by persistence of symptoms despite adequate anticoagulation for at least three months. It commonly includes persistent dyspnoea and reduced exercise tolerance.

How is PES related to chronic thromboembolic pulmonary hypertension (CTEPH) and chronic thromboembolic pulmonary disease (CTEPD)?

PES comprises a broad range of conditions; its most prominent manifestations include CTEPH and chronic thromboembolic pulmonary disease (CTEPD), along with right ventricular dysfunction and functional impairment.

Sep 30, 2026

Uploaded by Marglet