Percutaneous stent implantation successfully recanalized 9 pulmonary veins in 6 patients with iatrogenic pulmonary vein stenosis, restoring blood flow and leading to clinical improvement.
Does percutaneous balloon angioplasty with stenting improve clinical outcomes and restore blood flow in patients with iatrogenic pulmonary vein stenosis?
Percutaneous balloon angioplasty with self-expandable stent implantation is a feasible and effective minimally invasive treatment for iatrogenic pulmonary vein stenosis.
Absolute Event Rate: 0% vs 0%
Abstract Iatrogenic pulmonary vein stenosis (PVS) is a rare but serious complication of atrial fibrillation ablation, occurring in 1–4% of cases. Its clinical manifestations such as dyspnea, recurrent pulmonary infections and hemoptysis are often nonspecific, leading to delays in diagnosis and treatment, that can significantly impair patients' quality of life. This study presents the first Polish experience with percutaneous PVS treatment and introduces an novel therapeutic model for managing this challenging condition. Six patients diagnosed with PVS were analyzed. Diagnosis was confirmed using computed tomography (CT) and transesophageal echocardiography (TEE), which played a crucial role in the evaluation process. All patients were qualified for percutaneous intervention. Procedures were performed in general anestesia under TEE guidance for precise transeptal puncture. After introducing the steerable sheath into the left atrium balloon angioplasty with selfexpandable stent implantation was performed under intravascular ultrasound guidance. A total of nine pulmonary veins were successfully recanalized with the implantation of nine stents (mean diameter : 9.6 4–14, mean lenght 27.6 20–40 mm), restoring blood flow and leading to significant clinical improvement. In one patient, the procedure was terminated with balloon angioplasty due to the developed network of collaterals and the lack of technical possibilities to recanalize the main vessel. The present study highlights both the diagnostic challenges associated with PVS and the effectiveness of a minimally invasive percutaneous approach. The proposed treatment model, developed as part of this innovative project, lays the foundation for a comprehensive therapeutic program for iatrogenic PVS in Poland, aiming to improve early detection, optimize management strategies, and enhance patient outcomes.For image description, please refer to the figure legend and surrounding text.
Pietrasik et al. (Sun,) reported a other. Percutaneous stent implantation successfully recanalized 9 pulmonary veins in 6 patients with iatrogenic pulmonary vein stenosis, restoring blood flow and leading to clinical improvement.