While pulmonary endarterectomy (PEA) is the primary treatment in chronic thromboembolic pulmonary hypertension (CTEPH), it is not feasible for at least 40% of patients. Balloon pulmonary angioplasty (BPA) has emerged as an alternative for these patients.The International Balloon Pulmonary Angioplasty (BPA) Registry aimed to assess practices and outcomes across 18 centers in the U.S., Europe, and Japan. The registry enrolled 500 patients from March 2018 to March 2020, with follow-up through March 2022. Data from 484 patients were analyzed.
- Regional differences were noted, particularly with Japan treating more elderly women, using less sedation, and performing more intensive balloon pulmonary angioplasty protocols.
- Predictors of balloon pulmonary angioplasty complications included female sex, treatment in Europe/US, use of pulmonary hypertension medications, and higher baseline pulmonary vascular resistance (PVR).
- Patients underwent a median of 5 BPA sessions over ~5 months, resulting in:
- 38% reduction in mean pulmonary arterial pressure (mPAP)
- 57% reduction in pulmonary vascular resistance
- Improved oxygenation, functional class, exercise capacity, and biomarkers.
- Balloon pulmonary angioplasty-related complications occurred in 11.3% of sessions and 33.9% of patients, mainly hemopthysis. No 30-day mortality was observed.
Conclusions
Balloon pulmonary angioplasty is effective in improving clinical and hemodynamic outcomes in chronic thromboembolic pulmonary hypertension patients, with an acceptable safety profile. Greater center experience was linked to better outcomes, especially in pulmonary vascular resistance reduction.
Read full article at this link https://pubmed.ncbi.nlm.nih.gov/40499982/
Citation
Lang IM, Brenot P, Bouvaist H, Fadel E, Jaïs X, Madani MM, Guth S, Kurzyna M, Simonneau G, Wiedenroth CB, Mahmud E, Shimokawahara H, Bashir R, Delcroix M, Frantz R, Gerges C, Godinas L, Heresi GA, Jansa P, Jenkins DP, Hoole SP, Ogo T, Pepke-Zaba J, Satoh T, Vonk-Noordegraaf A, Witkin A, Bowers D, Kim NH, Matsubara H. Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension: Results of an International Multicenter Prospective Registry. J Am Coll Cardiol. 2025 Jun 17;85(23):2270-2284. doi: 10.1016/j.jacc.2025.04.021. PMID: 40499982.