Pulmonary vascular disease & thromboembolism
Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension: A Nationwide Prospective Multicenter Registry in Japan (J-BPA)
Authors' conclusion
No significant differences were observed in efficacy and periprocedural mortality between low- and high-volume hospitals. However, the significantly lower rate of severe complications in high-volume hospitals indicates that BPA may be safer in high-volume hospitals.
Study context
- Population
- Patients with chronic thromboembolic pulmonary hypertension undergoing balloon pulmonary angioplasty (BPA) in Japan, April 2018–March 2023
- Participants
- 1,202 patients5,207 procedures
- Exposure
- High-volume vs low-volume BPA hospitals
- Outcome
- Efficacy of BPA: symptoms, clinical parameters and hemodynamics (PVR reduction)
Methodological detailsnationwide, consecutive patients, 44 hospitals
- Nationwide
- Consecutive patients
- 44 hospitals
Main finding
As reported in the abstract
Reduction in pulmonary vascular resistance
55.6%
Periprocedural BPA-related mortality
0.2%
Observational data: associations, not effects.
Further findings
Procedures in low-volume hospitals
- Low-volume hospitals (35; 79.5%) performed this share of all BPA procedures
- 40.8%
Mortality risk (multivariable Cox regression)
- Higher right atrial pressure associated with increased mortality risk
- High-volume hospitals associated with reduced mortality risk
Efficacy and periprocedural mortality, low- vs high-volume hospitals
- No significant differences
Safety
Severe periprocedural complications
Severe lung injury
Balloon overdilatation
Mechanical ventilation
- Severe periprocedural complications: P<0.001
Original publication
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