Pulmonary vascular disease & thromboembolism
Procedural Volume and Outcomes After Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension
Main finding · Composite of BPA-related complicationsResult — go to the resultAdjusted odds ratio 1.60 95% CI 1.08–2.36Authors' conclusion
BPA-related complications demonstrated a complex relationship with procedural volume, while severe complications remained uncommon. The attenuation of hospital- and operator-level associations after mutual adjustment suggests that procedural volume alone may not adequately characterize BPA safety. Further studies incorporating lesion- and procedural-level characteristics and standardized complication ascertainment are warranted.
Study context
- Population
- Balloon pulmonary angioplasty (BPA) sessions for chronic thromboembolic pulmonary hypertension in the Japanese Structural Heart Diseases registry between 2021 and 2024
- Participants
- 5,403 BPA sessions
- Exposure
- Hospital and operator BPA volume and BPA-related complications
- Outcome
- Composite of BPA-related complications
Methodological detailsmixed-effects logistic regression accounting for hospital and operator clustering
- Mixed-effects logistic regression accounting for hospital and operator clustering
Main finding
As reported in the abstract
Adjusted odds ratio
1.60
95% CI 1.08–2.36
P = 0.019
- BPA-related complications
- 751 sessions (13.9%)
Observational data: associations, not effects.
Further findings
Hospital and operator volume as continuous variables
- Each associated with complications when modeled separately; neither independently associated after mutual adjustment
Complications less susceptible to differences in ascertainment (restricted analysis)
- Complications
- 135
- No statistically significant association for either volume measure
- Smaller number of events limited statistical precision
Safety
Severe complications
- Periprocedural deaths
- 3
- Requiring invasive mechanical ventilation
- 6
- Requiring extracorporeal membrane oxygenation
- 7
Original publication
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