Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension: State of the art

Jin, Qi; Zhao, Zhihui; Luo, Qin; Zhao, Qing; Liu, Yan; Zhang, Yi; Li, Xin; Yang, Tao; Zeng, Qingpeng; Xiong, Changming; Liu, Zhihong

doi:10.12998/wjcc.v8.i13.2679

Cited by 27 publications

(49 citation statements)

References 159 publications

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“…36 Where BPA is conducted on total occlusions, microcatheters and wires with higher tip loads and small-diameter balloons are used. 13,37 Overall, periprocedural mortality rates during BPA range from 0 to 10% across several BPA studies 1,18 with the latest French BPA study reporting periprocedural deaths related to severe lung injury in 2% of patients. 7…”

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confidence: 99%

Advances in balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension

et al. 2021

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Balloon pulmonary angioplasty (BPA) is an emerging treatment option for patients with chronic thromboembolic pulmonary hypertension (CTEPH) who have inoperable, segmental/subsegmental disease, or residual disease after pulmonary endarterectomy (PEA). In the past decade, advances in the techniques for BPA have led to better clinical outcomes with improvements in hemodynamics, pulmonary perfusion, exercise tolerance, functional capacity, and quality of life. We present the experience with BPA at our University, the largest CTEPH center in the world, followed by reviewing the published data regarding the efficacy and safety of BPA in patients with CTEPH. There is increasing evidence to support that the initial hemodynamic improvement is sustained for â¥3 years after the procedure. Although infrequent, complications observed with BPA are associated with pulmonary vascular injury or rarely reperfusion pulmonary edema. As the technique for percutaneous pulmonary artery revascularization has improved, the procedural risk and complications have continued to decrease. This promising technique continues to develop and future research is required to demonstrate the long-term benefits of BPA, standardize the technique, and define a uniform institutional infrastructure for providing BPA as a part of the treatment of CTEPH.

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confidence: 99%

Advances in balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension

et al. 2021

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“…Source: Jin et al 2020. [ 72 ] Reproduced from Baishideng Publishing Group under a Creative Commons (CC BY-NC-ND 4.0) licence.…”

Section: Balloon Pulmonary Angioplastymentioning

confidence: 99%

Balloon Pulmonary Angioplasty: State of the Art

2021

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Balloon pulmonary angioplasty (BPA) is a novel technique for the treatment of chronic thromboembolic pulmonary hypertension. While cardiologists need no introduction to the concept of balloon angioplasty, BPA has its own particular challenges. This article aims to provide the reader with an overview of BPA, starting with an introduction to chronic thromboembolic disease (CTED), the standard management of chronic thromboembolic pulmonary hypertension (CTEPH), technical challenges faced when performing BPA and the evidence base supporting its use. The second part of the article will focus on the future of BPA, in particular the areas where research is required to establish an evidence base to justify the role of BPA in CTEPH and CTED treatment.

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“…In experienced centers, reperfusion edema is now a rare occurrence. Lung injury is now the most common complication due to wire injury, balloon overdilation, or high-pressure injection of contrast medium [108], with an incidence of 5.9-17.8% [109][110][111]. Minor hemoptysis likely reflects minor vascular injury and generally resolves spontaneously and has an incidence of 7-14% [110,111].…”

Section: Balloon Pulmonary Angioplasty (Bpa)mentioning

confidence: 99%

“…Outcomes of BPA BPA has been reported to improve shortand long-term outcomes in multiple domains [13,79,106,108,[110][111][112][113] (selected studies listed in Table 1). BPA has been associated with improvements in hemodynamics [110], 6MWD [112], cardiopulmonary exercise testing [114], RV systolic function [99,100,106,107,115,116], and quality of life [106].…”

Section: Balloon Pulmonary Angioplasty (Bpa)mentioning

confidence: 99%