Abstract Background Occlusion lesions present as a challenge for balloon pulmonary angiography (BPA) in Takayasu arteritis associated pulmonary lesions. Currently, there is a lack of guidance for performing BPA in occluded lesions. Purpse We aimed to present the experience of addressing occlusion lesions in Takayasu arteritis in our centre, and demonstrate techniques and equipment, which might provide insight into the treatment of occluded lesions in Takayasu arteritis. Methods We enrolled consecutive patients diagnosed with Takayasu arteritis and pulmonary artery involvement. Patients who underwent pulmonary angiography were included. Results In this study, sixty-six patients with Takayasu arteritis and occluded lesions in pulmonary arteries were included. A total of 182 occluded lesions were identified, and 59.34% lesions were addressed. In all kinds of occluded lesions, orifice occluded lesions (37.91%) were most observed, while round-head occluded lesions (13.74%) had the lowest proportions. Compared with subtotal occlusions, total occlusions more commonly used guide-extension catheter than subtotal occlusions (70.21% vs. 40.63%, P0.001). Moreover, 69.23% orifice occluded lesions warrant hard-tip wire to revascularize the lesions, while only 3.13% of subtotal occluded lesions used. The success rate of BPA declined in the following range: subtotal occlusions (100%), pointed head occlusions (96%), round head occlusions (68.42%) and orifice occlusions (43.75%). Logistic regression found that irregular anticoagulation was associated with 9-fold increased risk of restenosis (OR=9.75, 95% CI 1.34-70.966, P=0.025), whereas baseline hemodynamics and inflammatory parameters was not associated with the occurrence of restenosis. Conclusions The techniques and devices illustrated in this study might guide the BPA performance in addressing total occlusion. After successfully revascularizing occluded lesions, regular anticoagulation is advised.Classificion of occluded lesions One case of treated occluded lesion
Yang et al. (2025) studied this question.