Balloon Pulmonary Angioplasty: State of the Art

Coghlan, J G; Rothman, Alexander; Hoole, Stephen P.

doi:10.15420/icr.2020.14

Cited by 20 publications

(15 citation statements)

References 65 publications

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“…Preprocedural pulmonary vasodilatation with oxygen therapy has also been demonstrated to lower mPAP, and similarly may be beneficial 29 . Second, by optimizing the procedural factors for example, limiting the number of segments treated until mPAP has been sufficiently lowered reduces the risk of ALI 30 . Another approach is to treat all accessible vessels with a stepwise increase in balloon size to avoid vessel over‐dilatation 31 .…”

Section: Discussionmentioning

confidence: 99%

“…29 Second, by optimizing the procedural factors for example, limiting the number of segments treated until mPAP has been sufficiently lowered reduces the risk of ALI. 30 Another approach is to treat all accessible vessels with a stepwise increase in balloon size to avoid vessel over-dilatation. 31 Pressure wire guided BPA, limiting the distal pressure to <35 mmHg may also achieve similar results.…”

Section: Prevention Of Alimentioning

confidence: 99%

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Acute lung injury after balloon pulmonary angioplasty results in a similar haemodynamic response and possible clinical advantage at follow‐up

et al. 2022

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Acute lung injury (ALI) is a common but poorly defined and understood complication of balloon pulmonary angioplasty (BPA) for chronic thromboembolic pulmonary hypertension (CTEPH). Little data are available on the medium term clinical outcomes of BPA complicated by ALI. We analyzed per-procedure data from 282 procedures in 109 patients and per-patient data from 85 patients. Serial right heart catheterization at baseline, after each BPA and at 3-month follow-up measured pulmonary vascular resistance (PVR), mean pulmonary artery pressure (mPAP), and cardiac output (CO). ALI (ALI+) was identified by chest radiography alone (ALI r +) or in association with hypoxia clinically (ALI cr +). Procedural predictors of ALI and patient outcomes at 3-months were compared no ALI (ALI−). ALI+ occurred in 17/ 282 (6.0%) procedures (ALI cr +: 2.5%, ALI r +: 3.5%). Prevailing haemodynamics (PVR: p < 0.01; mPAP: p < 0.05) at a procedural and patient level, as well as number of BPA sessions (p < 0.01), total number of vessels (p < 0.05), and occlusions (p < 0.05) treated at a patient level predicted ALI+. Those with ALI had greater percentage improvement in ΔCAMPHOR symptoms score (ALI+: −63.5 ± 35.7% (p < 0.05); ALI cr +: −84.4 ± 14.5% (p < 0.01); ALI−: −27.2 ± 74.2%) and ΔNT-proBNP (ALI cr +: −78.4 ± 11.9% (p < 0.01); ALI−: −42.9 ± 36.0%) at follow-up. There was no net significant difference in haemodynamic changes in ALI+ versus ALI− at follow-up. ALI is predicted by haemodynamic severity, number of vessels treated, number of BPA sessions, and treating occlusive disease. ALI in this cohort was associated with a clinical advantage at follow-up.

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Section: Discussionmentioning

confidence: 99%

Section: Prevention Of Alimentioning

confidence: 99%

Acute lung injury after balloon pulmonary angioplasty results in a similar haemodynamic response and possible clinical advantage at follow‐up

et al. 2022

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“…Work continued refining the procedure and once BPA was performed in a staged manner, the risk of complications was significantly reduced. 21,24 At our institution, BPA is performed by vascular interventional radiologists. As the CTEPH patient volume and case complexity grew, IR reevaluated their resources lead to the addition of an APN to their multidisciplinary team to assist with preprocedural evaluations and postprocedure follow up.…”

Section: Apn Role: Bpamentioning

confidence: 99%

PH Professional Network: The Role of the Advanced Practice Nurse With Patients Undergoing Pulmonary Thromboendarterectomy and Balloon Pulmonary Angioplasty for CTEPH

Nelson¹,

Miller²,

Salveson³

2022

Advances in Pulmonary Hypertension

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Advanced practice nurses play an integral role in the management of chronic thromboembolic pulmonary hypertension patients undergoing pulmonary thromboendarterectomy and balloon pulmonary angioplasty. As integral members of the multidisciplinary team, advance practice nurses assist chronic thromboembolic pulmonary hypertension patients in the presurgical, postsurgical, and procedural settings by ensuring appropriate referral, workup, evaluation, and education.

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“…In the presented case, PE may have been promoted by COVID-19 and the use of oestrogen contraception for the treatment of acne vulgaris. Treatment of PE should be initiated immediately to prevent dramatic complications (13)(14)(15) .…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 infection, hormonal contraception and pulmonary embolism in a 17-year-old female patient

Szydłowski¹,

Kusa²,

Kocot³

et al. 2022

Pediatr Med Rodz

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The paper presents the history of a 17-year-old patient admitted to the paediatric cardiology department in a life-threatening condition with dyspnoea, blood desaturation up to 90% and chest pain. The patient contracted COVID-19 (she was not vaccinated), and additionally treated her acne with oestrogen hormonal drugs. Computed tomography of the chest revealed massive embolic changes in the pulmonary artery and its branches. After introduction of heparin under the control of activated partial thromboplastin time and then warfarin under the control of international normalised ratio (INR), regression of changes was achieved; however, the arterial vessel narrowed up to the upper lobe of the right lung. During cardiac catheterisation, the vessel was widened with a balloon and successfully opened. Follow-up echocardiography showed regression of changes, the dimensions of the right heart decreased, and the features of pulmonary hypertension disappeared. During the exercise test, she reached stage 4. After 2 months, to avoid patient exposure to radiation, follow-up magnetic resonance imaging of pulmonary vessels was performed instead of computed tomography, showing partial restoration of the artery. Currently, the patient is still taking warfarin (INR 2.5–3.5), is in good general condition and a lung scan is planned in the future.

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Balloon Pulmonary Angioplasty: State of the Art

Cited by 20 publications

References 65 publications

Acute lung injury after balloon pulmonary angioplasty results in a similar haemodynamic response and possible clinical advantage at follow‐up

Acute lung injury after balloon pulmonary angioplasty results in a similar haemodynamic response and possible clinical advantage at follow‐up

PH Professional Network: The Role of the Advanced Practice Nurse With Patients Undergoing Pulmonary Thromboendarterectomy and Balloon Pulmonary Angioplasty for CTEPH

SARS-CoV-2 infection, hormonal contraception and pulmonary embolism in a 17-year-old female patient

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