Pulmonary vascular disease & thromboembolismCohort study
Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension
- Prospective registry study
- multicentre
- international
- consecutive enrolment
Authors' conclusion
Our data are in line with previous reports on changes of clinical and hemodynamic parameters and complication rates of BPA. Centers with more experience providing BPAs were more likely to achieve a higher percentage decrease in PVR.
Study context
- Population
- Patients with chronic thromboembolic pulmonary hypertension treated with balloon pulmonary angioplasty (BPA) at 18 established centres in the US, Europe and Japan484 analysed
- Participants
- 500 patients
Main finding
As reported in the abstract
Decrease in mPAP
15-mm Hg (38%)
Decrease in pulmonary vascular resistance (PVR)
332 dynes/s/cm-5 (57%)
Increase in arterial saturation
3.2%
P for haemodynamic changes
P < 0.001
Observational data: associations, not effects.
Further findings
Functional class, 6-minute walk distance, NT-proBNP, Borg dyspnoea index
- Significant improvements
Independent predictors of complications during BPA
- Female sex, procedure in Europe/US, pulmonary hypertension medications at any time, higher baseline PVR
Regional differences (Japan vs Europe/US)
- Japan: fewer prior pulmonary endarterectomy, more elderly women; less medical pretreatment, more jugular access, more segments and occlusive lesions treated, less conscious sedation, less contrast and radiation, shorter intervals between sessions
Death within 30 days of BPA
- Deaths
- 0
Safety
BPA complications (mostly hemoptyses)
- Sessions with complications
- 11.3%
- Patients with complications
- 33.9%
Original publication
Summarised from the published abstract; every number is checked against it