Macitentan to Prevent PRVO

Exclusion Criteria

• •Contraindication for anticoagulation
• •Allergy or contraindications to Macitentan or any other endothelin receptor antagonist.
• •Surgical interventions to treat PE including catheter-directed thrombolysis, catheter-based thrombectomy, or surgical pulmonary embolectomy.
• •Known inherited or acquired hypercoagulable states
• •History of pulmonary embolism prior to index PE
• •History of pulmonary hypertension including Group 1 (Primary pulmonary hypertension), Group 2 (secondary to left heart disease), Group 3 (secondary to lung disease), Group 4 (Chronic thromboembolic pulmonary hypertension)
• •Severe chronic obstructive pulmonary disease
• •Severe uncontrolled asthma
• •Pregnancy or fertility treatment
• •Breastfeeding
• •Life expectancy is less than 6 months
• •History of radiation therapy to the chest
• •Current or previous use within 90 days of an endothelin-receptor antagonist, prostacyclin analogue, phosphodiesterase type 5 inhibitor, or nitric oxide donor.
• •Severe allergic reaction to iodine contrast
• •Subjects receiving CYP3A4 and CYP2C9 inhibitors or inducers such as rifampin, ritonavir, fluconazole, amiodarone
• •Not able to read or understand the English language