Chronic thromboembolic pulmonary

Bosentan (Tracleer ) Actelion, Switzerland ETA/ETB receptor Grade III and IV PAH and chronic thromboembolic pulmonary hypertension (European approval in 2002 as orphan medicine) Program for CHF was terminated in phase III... 

Thrombotic (blood clot) events, and subsequent complications, are a leading cause of morbidity and mortality in the general population.1 In 2005, it was estimated that there were more than 900,000 total venous thromboembolism events in the United States,2 two thirds of which were acquired in hospital. More than 600,000 of those were nonfatal venous thromboembolism events. Nearly 300,000 were fatal events, including more than 2,200 cases of deep venous thrombosis and 294,000 cases of pulmonary embolism. The majority deaths (93%) were due to sudden fatal pulmonary embolism, or were a consequence of undiagnosed venous thromboembolism. It was estimated that 340,000 patients developed complications from venous thromboembolism, including 336,000 with postthrombotic syndrome and 3,300 with chronic thromboembolic pulmonary hypertension. 

Galie N, Kim N. Pulmonary Microvascular Disease in Chronic Thromboembolic Pulmonary Hypertension. Proc Am Thorac Soc 2006 3 571-6. 

Tunariu N, Gibbs SJ, Win Z, et al. Ventilation-perfusion scintigraphy is more sensitive than multidetector CTPA in detecting chronic thromboembolic pulmonary disease as a treatable cause of pulmonary hypertension. J Nucl Med 2007 48 680-4. 

Auger W, Kim NH, Kerr KM, Test VJ, Fedullo PF. Chronic thromboembolic pulmonary hypertension. Clin Chest Med 2007 28 255-2 69. 

WHO group IV includes patients with chronic thrombotic and embolic disease. For those with chronic thromboembolic disease, diagnosis and well-timed surgery may be curative if performed at a center proficient in performing pulmonary thromboendarterectomies. However, even with successful thromboendarterectomy... 

Fadel E, Riou JY, Mazmanian M et al. Pulmonary thromboendarterectomy for chronic thromboembolic obstruction of the pulmonary artery in piglets. J Thorac Cardiovasc Surg 1999 117 787 -793. 

Endrys J, Hayat N, Cherian G. Comparison of bronchopulmonary collaterals and collateral blood flow in patients with chronic thromboembolic and primary pulmonary hypertension. Heart 1997 78 171-176. 

Observational studies In 11 patients with severe pulmonary hjqjertension, six due to primary pulmonary arterial hjqjertension and four due to chronic thromboembolic disease, inhaled nitric oxide was used either alone or combined with a phosphodiesterase t5q)e 5 inhibitor [11. After 6 months of treatment, seven patients had clinical deterioration that was reversed on adding a phosphodiesterase t5q)e 5 inhibitor. One died after 8 months and another underwent pulmonary transplantation after 9 months. 

The scope of the medical problems which require the use of anticoagulant drugs cannot be overstated. Arterial thrombosis is a major contributor to the number one (acute myocardial infarction), number three (stroke) and number four (renal) causes of death in the United States (1J. Venous thromboembolism is the most common non-surgical cause of death in patients hospitalized for major orthopedic procedures, the most frequent non-obstetrical cause of postpartum death, and a major cause of death in patients with chronic cardiac and pulmonary disease (1 ). Venous thrombosis is estimated to lead to the hospitalization of approximately... 

Chronic administration increases the incidence of cholesterolic gallstones twofold. It also causes a small increase in thromboembolic phenomenon, pulmonary embolism, intermittent claudication, and angina pectoris. The drug may increase the incidence of bowel cancer. Overall, clofibrate cannot be classified as carcinogenic in humans. 

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