Stent-based pulmonary angioplasty for isolated PPAS had a 45.8% 3-year incidence of in-stent restenosis, but estimated 5- and 10-year survival rates were 90.4% and 80.4%.
Cohort (n=23)
No
Does stent-based pulmonary angioplasty improve hemodynamics, functional capacity, and long-term survival in adults with isolated peripheral pulmonary artery stenosis?
Stent-based angioplasty for isolated peripheral pulmonary artery stenosis provides excellent long-term survival and hemodynamic improvement, though frequent in-stent restenosis necessitates structured surveillance and reintervention.
BACKGROUND: Isolated peripheral pulmonary artery stenosis (PPAS) is a rare condition without standardized therapeutic strategies.Short-term clinical benefits of stent implantation have been reported; however, long-term durability and the incidence and determinants of instent restenosis (ISR) remain unclear. METHODS:This single-center retrospective study included 23 consecutive adults with isolated PPAS who underwent stent-based angioplasty between 2007 and 2024.Changes in hemodynamics, six-minute walk distance, and long-term survival were assessed.Predictors of ISR were evaluated using Cox proportional hazards models with a patient-level frailty term to account for within-patient clustering.RESULTS: Among 23 patients, 479 stents were implanted.Mean pulmonary arterial pressure (mPAP), pulmonary vascular resistance, and six-minute walk distance significantly improved following stent-based angioplasty.The 3-year cumulative incidence of ISR was 45.8%.Smaller stent diameter (hazard ratio HR: 0.582, 95% confidence interval CI: 0.381-0.889,P = 0.012), longer stent length (HR: 1.027, 95% CI: 1.005-1.049,P = 0.017), and higher mPAP at stenting (HR: 1.017, 95% CI: 1.000-1.034,P = 0.045) were independently associated with ISR. J o u r n a l P r e -p r o o fAmong lesions requiring reintervention, the 3-year cumulative incidence of recurrent ISR was 52.0%.Despite frequent ISR, most lesions were successfully retreated, with sustained improvements in hemodynamics and functional capacity.Estimated 5-and 10-year survival rates were 90.4% and 80.4%, respectively. CONCLUSIONS:In isolated PPAS, ISR appears to be common and potentially manageable through structured surveillance and timely reintervention.This strategy is associated with preserved favorable clinical outcomes and long-term survival, potentially serving as a bridge to, or a means of deferring, lung transplantation.
Kanezawa et al. (Wed,) conducted a cohort in Isolated peripheral pulmonary artery stenosis (PPAS) (n=23). Stent-based pulmonary angioplasty was evaluated on 3-year cumulative incidence of in-stent restenosis (ISR). Stent-based pulmonary angioplasty for isolated PPAS had a 45.8% 3-year incidence of in-stent restenosis, but estimated 5- and 10-year survival rates were 90.4% and 80.4%.
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