Balloon pulmonary angioplasty improved symptoms and hemodynamics in inoperable CTEPH or residual PH after PEA with manageable complications over nine years.
Does balloon pulmonary angioplasty improve symptoms and hemodynamics in patients with inoperable CTEPH or residual PH after PEA?
Balloon pulmonary angioplasty appears to be a safe and effective strategy for improving symptoms and hemodynamics in patients with inoperable CTEPH or residual PH after PEA, though procedural complications like hemoptysis and dissection can occur.
Absolute Event Rate: 0% vs 0%
Abstract Background Balloon pulmonary angioplasty (BPA) has been developed as an alternative and less-invasive treatment strategy for chronic thromboembolic pulmonary hypertension (CTEPH), but therapeutic efficacy and technical safety of the technique must be established. Purpose The aim of this study is to examine the effects of BPA in patients with inoperable disease or with residual pulmonary hypertension (PH) after pulmonary endarterectomy (PEA). Methods From June 2015 to May 2024, symptomatic (WHO functional class ≥II) inoperable CTEPH patients and patients with residual PH after PEA were enrolled. At baseline and after three to six months after last BPA session all patients underwent clinical evaluation, six-minute walking distance (6MWD) and right heart catheterization (RHC). Data are presented as median and interquartile range. The comparison of the same parameter between before and after BPA wasconducted with a two-tailed T-test for paired data and the significance was assessed with the Wilcoxon Signed-Rank Test for the asymmetric (non-normal) distribution of the data. For the survival analysis the date of baseline RHC was used as the start point to determine survival length. Results Seventy patients male 42%, median age 69 (55-76) years, 59 inoperable and 11 with residual PH after PEA were treated for a total of 197 sessions median number of sessions for each patient: 2 (1-4); median number of vessels treated for each patient: 5 (3-9). Sixty-seven patients were assuming pulmonary arterial hypertension specific drugs before BPA (22 were in combination therapy). All patients received life-long anticoagulation therapy (vitamin K-antagonist: 36 patients, direct oral anticoagulation: 33, fondaparinux: 1). Six pulmonary artery dissection and 8 hemoptysis with clinical impairment were documented during the procedures; 5 patients had access site complications. Clinical and haemodynamics results are shown in the Table. Survival starting from baseline RHC is showed in Kaplan–Meier Curve. Conclusions BPA is safe and effective at improving symptoms and hemodynamic profile in inoperable CTEPH patients and in patients with residual PH after PEA.Table Kaplan-Meier
Salvi et al. (Sat,) reported a other. Balloon pulmonary angioplasty improved symptoms and hemodynamics in inoperable CTEPH or residual PH after PEA with manageable complications over nine years.