Patient-Reported Long-Term Outcome of Balloon Pulmonary Angioplasty for Inoperable CTEPH

Abstract

Background Balloon pulmonary angioplasty (BPA) is a promising interventional treatment for inoperable chronic thromboembolic pulmonary hypertension (CTEPH). Evidence in favor of BPA is growing, but long-term data remain scarce. The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) is validated for the assessment of patients with pulmonary hypertension within three domains: symptoms, activity, and quality of life (QoL). The aim of the present study was to evaluate the long-term effects of BPA on these domains in patients with inoperable CTEPH. Methods Between March 2014 and August 2019, technically inoperable patients with target lesions for BPA were included in this prospective, observational study. CAMPHOR scores were compared between baseline (before the first BPA) and 6 months after the last intervention and also for scores assessed at annual follow-ups. Results A total of 152 patients had completed a full series of BPA interventions and a 28 (interquartile range [IQR]: 26–32) week follow-up. Further follow-up assessments including the CAMPHOR score were performed 96 (IQR: 70–117) weeks, 178 (IQR: 156–200) weeks, and 250 (IQR: 237–275) weeks after the last intervention. From baseline to the last follow-up, CAMPHOR scores for symptoms, activity, and QoL improved from 9 (IQR: 6–14) to 3 (IQR: 0–9) (p < 0.001), 8 (IQR: 5–12) to 4 (IQR: 2–8) (p < 0.001), and 5 (IQR: 2–9) to 1 (IQR: 0–5) (p < 0.001). Conclusion BPA leads to long-lasting, significant improvement of symptoms, physical capacity, and QoL in inoperable CTEPH patients.