Science and Research

Balloon pulmonary angioplasty for inoperable patients with chronic thromboembolic pulmonary hypertension: the initial German experience

Balloon pulmonary angioplasty (BPA) is an emerging treatment for patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH).We report on a prospective series of 56 consecutive patients who underwent 266 BPA interventions (median, five per patient) at two German institutions. All patients underwent a comprehensive diagnostic work-up including right heart catheterisation at baseline and 24 weeks after their last intervention.BPA resulted in improvements in WHO functional class, 6 min walk distance (mean change, +33 m), right ventricular function and haemodynamics, including a decline in mean pulmonary artery pressure by 18% and in pulmonary vascular resistance by 26%. Procedure-related adverse events occurred in 9.4% of the interventions. The most common complications were related to pulmonary vascular injury and consecutive pulmonary bleeding. Most of these events were asymptomatic and self-limiting, but one patient died from pulmonary bleeding, resulting in a mortality rate of 1.8%.BPA resulted in haemodynamic and clinical improvements but was also associated with a considerable number of complications, including one fatal pulmonary bleeding. As the effects of BPA on survival are unknown, randomised controlled outcome trials comparing BPA with approved medical therapies in patients with inoperable CTEPH are required to allow for appropriate risk-benefit assessments.

  • Olsson, K. M.
  • Wiedenroth, C. B.
  • Kamp, J. C.
  • Breithecker, A.
  • Fuge, J.
  • Krombach, G. A.
  • Haas, M.
  • Hamm, C.
  • Kramm, T.
  • Guth, S.
  • Ghofrani, H. A.
  • Hinrichs, J. B.
  • Cebotari, S.
  • Meyer, K.
  • Hoeper, M. M.
  • Mayer, E.
  • Liebetrau, C.
  • Meyer, B. C.

Keywords

  • Aged
  • *Angioplasty, Balloon
  • Female
  • Germany
  • Hemodynamics
  • Humans
  • Hypertension, Pulmonary/*physiopathology/*therapy
  • Male
  • Middle Aged
  • Prospective Studies
  • Pulmonary Artery/physiopathology
  • Pulmonary Embolism/*physiopathology/*therapy
  • Risk Assessment
  • Treatment Outcome
  • Vascular Resistance
  • Ventricular Function, Right
  • erj.ersjournals.com
Publication details
DOI: 10.1183/13993003.02409-2016
Journal: The European respiratory journal
Number: 6
Work Type: Original
Location: BREATH, UGMLC
Disease Area: PH
Partner / Member: JLU, MHH
Access-Number: 28596435
See publication on PubMed

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