Advanced Noninvasive Imaging to Guide Balloon Pulmonary Angioplasty

Fukui, Shigefumi; Sugimura, Koichiro; Ota, Hideki; Higuchi, Satoshi; Yaoita, Nobuhiro; Aoki, Tatsuo; Morita, Yoshiaki; Ogo, Takeshi; Fukuda, Tsuyoshi; Takase, Kei; Shimokawa, Hiroaki; Yasuda, Satoshi

doi:10.1007/978-3-030-95997-5_8

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…50 70 71 72 Associated improvements in right ventricle (RV) function and geometry were shown by echocardiography, cardiac magnetic resonance imaging, or NT-proBNP measurements. 73 74 75 76 77 78 79 Arterial blood oxygenation was also improved after BPA. 50 80 The positive effects of BPA on the hemodynamics, RV function, and oxygenation translated into improvements of functional status and exercise capacity, 65 81 82 83 as well as quality of life.…”

Section: Resultsmentioning

confidence: 88%

Monographic Issue on Pulmonary Hypertension: Medical and Interventional Treatment for Chronic Thromboembolic Pulmonary Hypertension

Delcroix,

Belge,

Maleux

et al. 2023

Semin Respir Crit Care Med

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Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare complication of acute pulmonary embolism. The reasons why clots do not resorb are incompletely understood, but the result is partial or complete fibrothrombotic obstruction of pulmonary arteries. A secondary microvasculopathy aggravates the pulmonary hypertension (PH) as a consequence of high flow and shear stress in the nonoccluded arteries. The treatment of CTEPH has long been purely surgical, but many patients were inoperable because of inaccessible lesions or severe comorbidities. Alternatives were developed, including medical therapy and more recently balloon pulmonary angioplasty (BPA). Depending on the generation of the obstructed vessels, the treatment will be surgical, up to the (sub)segmental level, or by BPA for more distal vessels. PH drugs are used to treat the microvasculopathy. The current paper describes the therapeutic management of inoperable patients: the medical approach with PH drugs used in mono- or combination therapy; the proper use of anticoagulants in CTEPH; the technique, indications, and results at short- and long-term of BPA; the multimodal approach for inoperable patients combining PH drugs and BPA; and the effects of rehabilitation. It shows the importance of a multidisciplinary approach to the disease.

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Section: Resultsmentioning

confidence: 88%

Monographic Issue on Pulmonary Hypertension: Medical and Interventional Treatment for Chronic Thromboembolic Pulmonary Hypertension

Delcroix,

Belge,

Maleux

et al. 2023

Semin Respir Crit Care Med

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“…To guide BPA, we adopted selective angiography and thin‐slice noncontrast‐enhanced CT using the lung window setting to visualize the bronchial tubes that normally run in along the pulmonary arteries (PA) (Figures 1d, 1e, 1f ). 2 The first BPA targeted right A3, A5, and A6, whereas the second one targeted right A7, A1, A2, A3, and A5, including optimization of the vessels treated in the first session, without any complications. After BPA, a significant decrease in BNP levels from 3,470 to 288 pg/mL and PAP from 120/28 (59) to 46/26 (33) mmHg had been noted.…”

Section: Case Descriptionmentioning

confidence: 99%

Balloon pulmonary angioplasty under awake veno‐arterial extracorporeal membrane oxygenation in a patient with class III obesity with chronic thromboembolic pulmonary hypertension complicated with multiple serious comorbidities

Sato,

Fukui,

Nakano

et al. 2024

Pulm. circ.

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Chronic thromboembolic pulmonary hypertension (CTEPH) is a chronic disease that can rapidly deteriorate into circulatory collapse when complicated by comorbidities. We herein describe a case involving a 43‐year‐old woman with class III obesity (body mass index of 63 kg/m2) and severe CTEPH associated with total occlusion of the left main pulmonary artery who subsequently developed circulatory collapse along with multiple comorbidities, including acute kidney injury, pulmonary tuberculosis, and catastrophic antiphospholipid syndrome. The patient was successfully treated with two sessions of rescue balloon pulmonary angioplasty with veno‐arterial extracorporeal membrane oxygenation (V‐A ECMO) support under local anesthesia without sedation, at cannulation and during the V‐A ECMO run, to avoid invasive mechanical ventilation. This case suggests the potential usefulness of rescue balloon pulmonary angioplasty under awake V‐A ECMO support for rapidly deteriorating, inoperable CTEPH in a patient with class III obesity complicated with multiple comorbidities.

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Advanced Noninvasive Imaging to Guide Balloon Pulmonary Angioplasty

Cited by 2 publications

References 18 publications

Monographic Issue on Pulmonary Hypertension: Medical and Interventional Treatment for Chronic Thromboembolic Pulmonary Hypertension

Monographic Issue on Pulmonary Hypertension: Medical and Interventional Treatment for Chronic Thromboembolic Pulmonary Hypertension

Balloon pulmonary angioplasty under awake veno‐arterial extracorporeal membrane oxygenation in a patient with class III obesity with chronic thromboembolic pulmonary hypertension complicated with multiple serious comorbidities

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