Interventional Imaging Roadmap to Successful Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension

Patel, Nimai; Hyder, Syed N.; Michaud, Erinleigh; Moles, Victor; Agarwal, Prachi P.; Rosenfield, Kenneth; Abe, Kohtaro; Haft, Jonathan W.; Visovatti, Scott; Cascino, Thomas; Auger, William R.; McLaughlin, Vallerie V.; Aggarwal, Vikas

doi:10.1016/j.jscai.2022.100429

Cited by 3 publications

(8 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…17,23 Lesion assessment based on careful S-iPA is vital for lesion characterization, and lesion severity may be fully appreciated only with an examination in orthogonal views because of the asymmetry of the stenosis. 17 When vessels appear angiographically patent by S-iPA but the corresponding venous return is an abnormal, adjunctive assessment with resting pressure gradient measurement is helpful in the identification of obstructive intravascular webbing. Such lesions are dilated with the ratio of proximal pressure (Pa) to distal pressure (Pd) as a guide until either brisk venous return or a Pd:Pa ratio >0.80 is achieved.…”

Section: Procedural Performancementioning

confidence: 99%

“…Guide extension catheters are particularly useful for deep coaxial engagement, allowing reduced contrast dose on S-iPA. 17,23 Lesion assessment based on careful S-iPA is vital for lesion characterization, and lesion severity may be fully appreciated only with an examination in orthogonal views because of the asymmetry of the stenosis. 17 When vessels appear angiographically patent by S-iPA but the corresponding venous return is an abnormal, adjunctive assessment with resting pressure gradient measurement is helpful in the identification of obstructive intravascular webbing.…”

Section: Procedural Performancementioning

confidence: 99%

“…Guide extension catheters are particularly useful for deep coaxial engagement, allowing reduced contrast dose on S-iPA. 17,23 Lesion assessment based on careful S-iPA is vital for lesion characterization, and lesion severity may be fully appreciated only with an examination in orthogonal views because of the asymmetry of the stenosis. 17 Figure 6 illustrates common lesion subtypes in a typical BPA procedure.…”

Section: Procedural Performancementioning

confidence: 99%

“…With the use of digital subtraction, 2 angiograms are performed for each lung during deep inspiratory breath holds in orthogonal projections. 17,18 Orthogonal imaging is achieved through the following:…”

Section: Anatomical Considerationsmentioning

confidence: 99%

“…Each perfusion zone corresponds to an individual pulmonary segment (Figure 1) and is assessed for the degree of hypoperfusion and disease characterization in the pulmonary artery branches supplying the zone. 17…”

Section: Anatomical Considerationsmentioning

confidence: 99%

See 4 more Smart Citations

Status and Future Directions for Balloon Pulmonary Angioplasty in Chronic Thromboembolic Pulmonary Disease With and Without Pulmonary Hypertension: A Scientific Statement From the American Heart Association

Aggarwal,

Giri,

Visovatti

et al. 2024

Circulation

Self Cite

View full text Add to dashboard Cite

Balloon pulmonary angioplasty continues to gain traction as a treatment option for patients with chronic thromboembolic pulmonary disease with and without pulmonary hypertension. Recent European Society of Cardiology guidelines on pulmonary hypertension now give balloon pulmonary angioplasty a Class 1 recommendation for inoperable and residual chronic thromboembolic pulmonary hypertension. Not surprisingly, chronic thromboembolic pulmonary hypertension centers are rapidly initiating balloon pulmonary angioplasty programs. However, we need a comprehensive, expert consensus document outlining critical concepts, including identifying necessary personnel and expertise, criteria for patient selection, and a standardized approach to preprocedural planning and establishing criteria for evaluating procedural efficacy and safety. Given this lack of standards, the balloon pulmonary angioplasty skill set is learned through peer-to-peer contact and training. This document is a state-of-the-art, comprehensive statement from key thought leaders to address this gap in the current clinical practice of balloon pulmonary angioplasty. We summarize the current status of the procedure and provide a consensus opinion on the role of balloon pulmonary angioplasty in the overall care of patients with chronic thromboembolic pulmonary disease with and without pulmonary hypertension. We also identify knowledge gaps, provide guidance for new centers interested in initiating balloon pulmonary angioplasty programs, and highlight future directions and research needs for this emerging therapy.

show abstract

Section: Procedural Performancementioning

confidence: 99%

Section: Procedural Performancementioning

confidence: 99%

“…Guide extension catheters are particularly useful for deep coaxial engagement, allowing reduced contrast dose on S-iPA. 17,23 Lesion assessment based on careful S-iPA is vital for lesion characterization, and lesion severity may be fully appreciated only with an examination in orthogonal views because of the asymmetry of the stenosis. 17 Figure 6 illustrates common lesion subtypes in a typical BPA procedure.…”

Section: Procedural Performancementioning

confidence: 99%

Section: Anatomical Considerationsmentioning

confidence: 99%

Section: Anatomical Considerationsmentioning

confidence: 99%

See 3 more Smart Citations

Status and Future Directions for Balloon Pulmonary Angioplasty in Chronic Thromboembolic Pulmonary Disease With and Without Pulmonary Hypertension: A Scientific Statement From the American Heart Association

Aggarwal,

Giri,

Visovatti

et al. 2024

Circulation

Self Cite

View full text Add to dashboard Cite

show abstract

Same‐Day Discharge Following Outpatient Balloon Pulmonary Angioplasty: A Single‐Center Experience

Saha,

Chidester,

Hall

et al. 2024

Pulm. circ.

View full text Add to dashboard Cite

show abstract

Chronic Thromboembolic Pulmonary Hypertension: How to Diagnose? A Case Report

Laksono,

Kusharsamita

2023

BIKDW

View full text Add to dashboard Cite

Background Chronic thromboembolic pulmonary hypertension (CTEPH) is a pulmonary embolism (PE) complication that is a primary cause of pulmonary hypertension (PH) and may lead to right heart failure and significant mortality especially when left untreated. Although CTEPH is the only cause of PH that is curable without needing to resort to lung transplant, it is often misdiagnosed due to the absence of diagnostic instruments and the absence of specific presenting symptoms. This also complicates the process of distinguishing between acute thromboembolic disease and the acute embolic event worsening of undiscovered CTEPH. Objective A better understanding of CTEPH is crucial, therefore we discuss a diagnosis rare case of CTEPH. Case Description A 44-year-old man presenting with syncope and chest discomfort who had no previous episodes of acute PE. Conclusion Computed Tomography Pulmonary Angiography (CTPA) is a significant test for identifying CTPEH. Oral anticoagulants may provide patients with CTEPH a safe and beneficial life-long treatment.

show abstract

Interventional Imaging Roadmap to Successful Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension

Cited by 3 publications

References 46 publications

Status and Future Directions for Balloon Pulmonary Angioplasty in Chronic Thromboembolic Pulmonary Disease With and Without Pulmonary Hypertension: A Scientific Statement From the American Heart Association

Status and Future Directions for Balloon Pulmonary Angioplasty in Chronic Thromboembolic Pulmonary Disease With and Without Pulmonary Hypertension: A Scientific Statement From the American Heart Association

Same‐Day Discharge Following Outpatient Balloon Pulmonary Angioplasty: A Single‐Center Experience

Chronic Thromboembolic Pulmonary Hypertension: How to Diagnose? A Case Report

Contact Info

Product

Resources

About