Chronic Thromboembolic Pulmonary Hypertension Associated with Venous Thoracic Outlet Syndrome
Bibliographic record
Abstract
Introduction: Several medical conditions are associated with the development of CTEPH, including splenectomy, cancer, and permanent intravascular devices. Venous thoracic outlet syndrome (vTOS) results from anatomical narrowing in the costoclavicular triangle, potentially leading to subclavian vein thrombosis and pulmonary embolism (PE). However, its potential association with CTEPH remains underrecognized. Methods: We retrospectively analysed all consecutive CTEPH patients with vTOS diagnosed and treated at the French referral centre for pulmonary hypertension (PH) between 2014 and 2022. Results: Among 1,443 CTEPH cases diagnosed during the study period, seven (0.48%) were associated with vTOS. Compared to other CTEPH patients, those with vTOS were younger (27 ± 5 vs. 62 ± 14 years; p < 0.001) and more frequently deemed inoperable (86% vs. 41%; p = 0.02). All patients with vTOS underwent balloon pulmonary angioplasty (BPA) alone (n = 6) or in combination with pulmonary endarterectomy (n = 1). BPA resulted in significant hemodynamic improvement. Six patients subsequently underwent surgical correction for vTOS and remained symptom-free, with no PH worsening or PE recurrence over a median follow-up of five years. Conclusion: vTOS-associated CTEPH is rare, affects younger patients, and is often inoperable. BPA is highly effective in improving hemodynamics. Awareness of this association is crucial for early recognition and optimal management. erj;66/suppl_69/PA927/TB1 T1 TB1 Baseline Median (IQR 25-75%) After treatment Median (IQR 25-75%) p value mPAP mmHg 40 (36-46) 19 (18-21) p=0.02 PVR, WU 7 (5-8.7) 1.6 (1.5-1.7) p=0.01 6MWD, m 478 (453-587) 600 (593-667) p=0.01 NYHA functional class, n (%) I-II 2 (28%) 7 (100%) p=0.02
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".