Panagiotis Karyofyllis1, Varvara Papadopoulou2, Vassilis Voudris2, Hiromi Matsubara3. 1. Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Sygrou Ave 356, Kallithea, 17674, Athens, Greece. pakar768@yahoo.gr. 2. Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Sygrou Ave 356, Kallithea, 17674, Athens, Greece. 3. Department of Clinical Science and Department of Cardiology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan.
Abstract
PURPOSE OF REVIEW: Chronic thromboembolic pulmonary hypertension (CTEPH) is the only potentially curable form of precapillary pulmonary hypertension. Although pulmonary endarterectomy (PEA) is the preferred management strategy, a significant number of CTEPH patients will have an inoperable disease. As drug therapy is not expected to offer relief from the mechanical component of the disease, the novel technique of balloon pulmonary angioplasty (BPA) has provided a new therapeutic option for patients with inoperable CTEPH. This review will discuss the contemporary use of BPA technique in inoperable CTEPH patients highlighting the effectiveness and safety of this therapeutic option. RECENT FINDINGS: Data supporting the role of BPA in inoperable CTEPH are limited to observational studies. However, these observational studies report consistent findings that BPA results in marked improvements in pulmonary hemodynamics and exercise capacity indicating its efficacy and safety as a treatment strategy in inoperable CTEPH patients. Summarizing, BPA is an emerging treatment option providing marked improvements in parameters affecting the outcome of CTEPH patients, but multicenter studies are needed to confirm the safety and the long-term efficacy of the procedure, before BPA can be recommended as an established treatment for CTEPH.
PURPOSE OF REVIEW: Chronic thromboembolic pulmonary hypertension (CTEPH) is the only potentially curable form of precapillary pulmonary hypertension. Although pulmonary endarterectomy (PEA) is the preferred management strategy, a significant number of CTEPHpatients will have an inoperable disease. As drug therapy is not expected to offer relief from the mechanical component of the disease, the novel technique of balloon pulmonary angioplasty (BPA) has provided a new therapeutic option for patients with inoperable CTEPH. This review will discuss the contemporary use of BPA technique in inoperable CTEPHpatients highlighting the effectiveness and safety of this therapeutic option. RECENT FINDINGS: Data supporting the role of BPA in inoperable CTEPH are limited to observational studies. However, these observational studies report consistent findings that BPA results in marked improvements in pulmonary hemodynamics and exercise capacity indicating its efficacy and safety as a treatment strategy in inoperable CTEPHpatients. Summarizing, BPA is an emerging treatment option providing marked improvements in parameters affecting the outcome of CTEPHpatients, but multicenter studies are needed to confirm the safety and the long-term efficacy of the procedure, before BPA can be recommended as an established treatment for CTEPH.
Authors: Marek Roik; Dominik Wretowski; Andrzej Łabyk; Katarzyna Irzyk; Barbara Lichodziejewska; Olga Dzikowska-Diduch; Dorota Piotrowska-Kownacka; Piotr Pruszczyk Journal: J Interv Cardiol Date: 2017-05-05 Impact factor: 2.279
Authors: Joanna Pepke-Zaba; Marion Delcroix; Irene Lang; Eckhard Mayer; Pavel Jansa; David Ambroz; Carmen Treacy; Andrea M D'Armini; Marco Morsolini; Repke Snijder; Paul Bresser; Adam Torbicki; Bent Kristensen; Jerzy Lewczuk; Iveta Simkova; Joan A Barberà; Marc de Perrot; Marius M Hoeper; Sean Gaine; Rudolf Speich; Miguel A Gomez-Sanchez; Gabor Kovacs; Abdul Monem Hamid; Xavier Jaïs; Gérald Simonneau Journal: Circulation Date: 2011-10-03 Impact factor: 29.690