BPA vs. PEA in CTEPH

Inclusion Criteria: * Diagnosed with chronic thromboembolic pulmonary hypertension according to current European society of cardiology/European Respiratory Society guidelines and eligible for both pulmonary endarterectomy and ballon pulmonary angioplasty by decision at the local multidisciplinary team conference and central adjudication committee * Written informed consent from the patient * Patient age \>17 and \<80 years * Able to understand and follow instructions and to participate in the entire study period Exclusion Criteria: * Life expectancy \<12 months * Co morbidities evaluated at the multidisciplinary team conference, that contributes significantly to the patients pulmonary hypertension * Not possible to perform balloon pulmonary angioplasty or pulmonary endarterectomy within 4 months after randomization. * Evaluated at multidisciplinary team conference that changes in pulmonary artery hypertension targeted therapy between baseline and 4 months follow-up is inevitable\* * Known pregnancy or positive urine Human chorionic gonadotropin screening test in fertile women * Previous balloon pulmonary angioplasty or pulmonary endarterectomy