Refined Balloon Pulmonary Angioplasty for Inoperable Patients with Chronic Thromboembolic Pulmonary Hypertension
Refined Balloon Pulmonary Angioplasty for Inoperable Patients with Chronic Thromboembolic Pulmonary Hypertension
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DOI：
10.1161/circinterventions.112.971077
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发表时间：
2012-12-01
影响因子：
5.6
通讯作者：
Matsubara, Hiromi
中科院分区：
文献类型：
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作者：
Mizoguchi, Hiroki;Ogawa, Aiko;Matsubara, Hiromi
背景-尽管球囊肺血管成形术(BPA)治疗不能手术的慢性血栓栓塞性肺动脉高压患者早在十多年前就有报道，但由于疗效和并发症的限制，其临床应用一直受到限制。方法和结果：68例不能手术的慢性血栓栓塞性肺动脉高压患者接受了BPA治疗。我们评估了肺动脉直径，并通过血管内超声确定了合适的球囊大小。我们以分期的方式在多个不同的程序中实施双酚A，以最大限度地提高疗效并降低再灌注性肺损伤的风险。每例患者共4次(2-8次)，每次3次(1-14次)血管扩张。世界卫生组织职能等级由3级提高到2级(P
Background-Although balloon pulmonary angioplasty (BPA) for inoperable patients with chronic thromboembolic pulmonary hypertension was first reported over a decade ago, its clinical application has been restricted because of limited efficacy and complications. We have refined the procedure of BPA to maximize its clinical efficacy.Methods and Results-Sixty-eight consecutive patients with inoperable chronic thromboembolic pulmonary hypertension underwent BPA. We evaluated pulmonary artery diameters and determined the appropriate balloon size by using intravascular ultrasound. We performed BPA in a staged fashion over multiple, separate procedures to maximize efficacy and reduce the risk of reperfusion pulmonary injury. A total of 4 (2-8) sessions were performed in each patient, and the number of vessels dilated per session was 3 (1-14). The World Health Organization functional class improved from 3 to 2 (P