Refined balloon pulmonary angioplasty-A therapeutic option in very elderly patients with chronic thromboembolic pulmonary hypertension

2017 ◽  
Vol 30 (3) ◽  
pp. 249-255 ◽  
Author(s):  
Marek Roik ◽  
Dominik Wretowski ◽  
Andrzej Łabyk ◽  
Katarzyna Irzyk ◽  
Barbara Lichodziejewska ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Elderly Patients ◽  
Therapeutic Option ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Very Elderly ◽  
Balloon Pulmonary Angioplasty ◽  
Thromboembolic Pulmonary Hypertension

scholarly journals Hemodynamic effects of balloon pulmonary angioplasty for the treatment of total and subtotal pulmonary artery occlusions in inoperable chronic thromboembolic pulmonary hypertension

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J Stepniewski ◽  
W Magon ◽  
R Przybylski ◽  
G Kopec
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Therapeutic Option ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Primary Efficacy ◽  
Efficacy And Safety ◽  
Funding Sources ◽  
Efficacy Outcome ◽  
Balloon Pulmonary Angioplasty ◽  
Thromboembolic Pulmonary Hypertension

Abstract Background Balloon pulmonary angioplasty (BPA) has become a therapeutic option for inoperable chronic thromboembolic pulmonary hypertension (CTEH). Despite significant improvement in the technique, treatment of subtotal (STO) and total (TO) pulmonary artery occlusions with BPA may pose risk, but the efficacy is unknown. Aim We aimed to study to assess safety and efficacy of BPA in STO/TO. Methods We included consecutive patients with inoperable CTEPH, who underwent BPA treatment. To evaluate the efficacy and safety we grouped all BPA sessions into those in which recanalization of at least one STO or TO was performed and into those without. The primary efficacy outcome was improvement in pulmonary vascular resistance (PVR) in BPA sessions with STO/TO recanalization as compared to those without. Results We analyzed 169 BPA sessions in 50 CTEPH patients. Out of a total number of 832 lesions subjected for BPA, 168 were classified as STOs or TOs [129 (15,5%) and 39 (4,7%) respectively]. Three (2,3%) STOs and 8 (20,5%) TOs were not recanalized despite repeated attempts. There were 90 BPA sessions with at least one STO/TO recanalization. Racanalization of at least one STO/TO was associated with a trend towards PVR improvement as compared to non-STO/TO BPAs (−69±162 vs −38±135 dyn s cm–5, p=0,19). Recanalization of STO/TO at the level of segmental pulmonary artery as compared to subsegmental-only STO/TO recanalizations or no-STO/TO recanalization was associated with significant PVR improvement (−126±192 vs −38±135 dyn s cm–5, p=0.007). The rate of complications was similar in STO/TO and non-STO/TO BPA sessions (14.4% vs 12.6%, p=0.56). Conclusions The use of BPA for the recanalization of subtotal and total PA occlusions is safe and effective. Recanalization of segmental STO/TOs leads to significant improvement in PVR. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Soluble ST2 as a Biomarker for Early Complications in Patients with Chronic Thromboembolic Pulmonary Hypertension Treated with Balloon Pulmonary Angioplasty

Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 133
Author(s):  
Marta Banaszkiewicz ◽  
Arkadiusz Pietrasik ◽  
Michał Florczyk ◽  
Piotr Kędzierski ◽  
Michał Piłka ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Troponin T ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Early Complications ◽  
Dynamic Changes ◽  
Soluble St2 ◽  
Time Points ◽  
Balloon Pulmonary Angioplasty ◽  
Thromboembolic Pulmonary Hypertension ◽  
Discharge From Hospital

Background: The aim of the study was to assess soluble ST2 (sST2) concentration and its dynamic changes in the periprocedural period in patients with chronic thromboembolic pulmonary hypertension (CTEPH) treated with balloon pulmonary angioplasty (BPA). Methods: We prospectively analyzed 57 procedures of BPA performed in 37 patients with CTEPH. Biomarkers, such as N-terminal pro B-type natriuretic peptide (NT-proBNP), troponin T (TnT), and sST2 were assessed at four time points: Before the BPA procedure, 24 h and 48 h after the procedure, and at the discharge from hospital. Each postprocedural period was assessed for complications. Results: Before the BPA procedure, median sST2 concentration was 26.56 ng/mL (IQR: 16.66–40.83 ng/mL). sST2 concentration was significantly higher 24 h and 48 h after the BPA compared to the baseline measurements (33.31 ng/mL (IQR: 20.81–62.56), p = 0.000 and 27.45 ng/mL (IQR: 17.66–54.45), p = 0.028, respectively). sST2 level 24 h after the BPA procedure was significantly higher in the group with complications compared to the group without complications in the postprocedural period (97.66 ng/mL (IQR: 53.07–126.18) vs. 26.86 ng/mL (IQR: 19.10–40.12), p = 0.000). Conclusions: sST2 concentration in patients with CTEPH treated with BPA changes significantly in the postprocedural period and is significantly higher in the group with complications in postprocedural period.

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