University of California, San Diego (UCSD)-CTEPH surgical classification

Last revised by Jeffrey Hocking on 15 Jun 2023

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 :

  • level 0

    • no evidence of thromboembolic disease in either lung

  • level 1

    • lesions starting in the main pulmonary arteries

  • level 1C

    • corresponding to complete occlusion of one main pulmonary artery

  • level 2

    • lesions starting at the level of lobar arteries or in the main descending pulmonary arteries

  • level 3

    • lesions starting at the level of the segmental arteries

  • 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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