The University of California, San Diego (UCSD)-CTEPH surgical classification defines chronic thromboembolic pulmonary hypertension (CTEPH) type and location, and is stratified into four levels, based on the most proximal extent of the thrombus 1,2 :
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level 0
no evidence of thromboembolic disease in either lung
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level 1
lesions starting in the main pulmonary arteries
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level 1C
corresponding to complete occlusion of one main pulmonary artery
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level 2
lesions starting at the level of lobar arteries or in the main descending pulmonary arteries
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level 3
lesions starting at the level of the segmental arteries
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Level 4
lesions starting at the level of the subsegmental arteries
Levels 1 - 3 lesions are operable with pulmonary thromboendarterectomy (PTE), while level 4 lesions are usually inoperable. While this is foremost a surgical classification, it can be utilized on CT imaging to assist with anticipating surgical appearances.
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