Balloon Pulmonary Angioplasty in Patients With Thromboembolic Pulmonary Hypertension
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.
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.
KeywordsChronic thromboembolic pulmonary hypertension Balloon pulmonary angioplasty Pulmonary endarterectomy
Compliance with Ethical Standards
Conflict of Interest
Panagiotis Karyofyllis has received lecture fees from Actelion Pharmaceuticals Hellas, Bayer Hellas, and GlaxoSmithKline.
Varvara Papadopoulou declares no potential conflicts of interest related with this article.
Vassilis Voudris is a section editor for Current Treatment Options in Cardiovascular Medicine.
Hiromi Matsubara has received lecture fees from Actelion Pharmaceuticals Japan, AOP Orphan Pharmaceuticals, Bayer Yakuhin, GlaxoSmithKline, Nippon Shinyaku, and Pfizer Japan, and a research grant from Nippon Shinyaku.
Human and Animal Rights and Informed Consent
All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).
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