Advances in treatment of chronic thromboembolic pulmonary hypertension

Tzoumas, Andreas; Peppas, Spyridon; Sagris, Μarios; Papanastasiou, Christos A.; Archontakis‐Barakakis, Paraschos; Bakoyiannis, Christos; Taleb, Adam; Kokkinidis, Damianos G.; Giannakoulas, George

doi:10.1016/j.thromres.2022.02.003

Cited by 6 publications

(7 citation statements)

References 84 publications

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“…Previous studies have underscored the emPHasis-10 questionnaire as a valid tool for longitudinally measuring the quality of life in patients with CTEPH. 23 Paul Hendriks and colleagues further demonstrated a moderate correlation between the emPHasis-10 score and 6MWD at baseline. 24 Notably, this correlation persisted both before and after BPA, establishing a comprehensive link between physical capacity and quality of life.…”

Section: Discussionmentioning

confidence: 95%

“…Consequently, the significance of quality of life as a crucial evaluation criterion cannot be overstated. Previous studies have underscored the emPHasis‐10 questionnaire as a valid tool for longitudinally measuring the quality of life in patients with CTEPH 23 . Paul Hendriks and colleagues further demonstrated a moderate correlation between the emPHasis‐10 score and 6MWD at baseline 24 .…”

Section: Discussionmentioning

confidence: 99%

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Safety and efficacy of balloon pulmonary angioplasty for technically operable chronic thromboembolic pulmonary hypertension

Wang,

Liu,

Tao

et al. 2023

Pulm. circ.

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Balloon pulmonary angioplasty (BPA) has been proven effective for addressing technically inoperable chronic thromboembolic pulmonary hypertension (CTEPH). However, the effectiveness of BPA in technically operable CTEPH patients who, for various reasons, did not undergo the procedure remains an area requiring exploration. This study sought to assess the safety and efficacy of BPA in such cases. We collected and reviewed data from CTEPH patients who underwent BPA in a consecutive manner. Following multidisciplinary team (MDT) decisions, patients were classified into two groups: technically inoperable (group A) and operable (group B). Group B comprised patients deemed technically suitable for pulmonary endarterectomy (PEA) but who did not undergo the procedure for various reasons. All patients underwent a comprehensive diagnostic work‐up, including right heart categorization at baseline and the last intervention. This study compared changes in hemodynamic parameters, functional capacity, and quality of life between the two groups. In total, 161 patients underwent 414 procedures at our center, with Group A comprising 112 patients who underwent 282 BPA sessions and group B comprising 49 patients who underwent 132 BPA sessions. Significantly, both groups exhibited improvements in hemodynamics, functional capacity, and quality of life. The occurrence rate of complications, including hemoptysis and lung injury, was similar [12 (63.2%) vs. 7 (36.8%), p = 0.68]. BPA demonstrated favorable outcomes in patients with proximal CTEPH who did not undergo pulmonary endarterectomy. However, the clinical impact of BPA in technically operable CTEPH was found to be less significant than in inoperable cases.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of balloon pulmonary angioplasty for technically operable chronic thromboembolic pulmonary hypertension

Wang,

Liu,

Tao

et al. 2023

Pulm. circ.

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“…7,8 Pulmonary endarterectomy (PEA) is the preferred treatment for CTEPH patients which can significantly improve symptoms and pulmonary hemodynamics. [9][10][11] It has been used for over 30 years since the first PEA, 12 the surgical technology and procedures are being continuously improved over time so that surgical morbidity and mortality continues to decrease. 13 The first PEA operation was done in 2002 in our center and has thus been performed for nearly 20 years until now.…”

Section: Introductionmentioning

confidence: 99%

Long-term Outcomes and Predictors of Chronic Thromboembolic Pulmonary Hypertension After Pulmonary Endarterectomy

Sun

Liu

et al. 2022

Clin Appl Thromb Hemost

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Background Pulmonary endarterectomy (PEA) is the preferred treatment for CTEPH patients which can significantly improve symptoms and pulmonary hemodynamics. Therefore, this retrospective study evaluated the long-term outcomes after pulmonary endarterectomy (PEA) and analyze the predictors of long-term outcomes for chronic thromboembolic pulmonary hypertension (CTEPH). Methods From 2002–2020, 76 CTEPH patients successfully discharged after PEA in Beijing Chaoyang Hospital were followed-up by scheduled clinical visits or telephone interviews. The follow-up time lasted for 18 years and median time was 7.29 years. Results The survival rate at 1,3,5,10,15 years postoperatively was 100.00%, 97.10%, 95.40%, 89.80% and 82.90%, respectively. Multivariate logistics regression analysis showed that postoperative mPAP (hazard ratio: 1.144; 95%confidence interval: 1.018–1.285; P = 0.023) was associated with a higher risk of late death, right atrium right and left diameters (hazard ratio: 1.113; 95%confidence interval, 1.006–1.231; P = 0.038) were associated with a higher risk of major adverse events. Conclusion Pulmonary endarterectomy is an effective way to treat CTEPH. Long-term outcome is excellent for patients who undergoing pulmonary endarterectomy who survived from peri-operation time. Postoperative mPAP is a significant prognostic factor for long-term death and right atrium right and left diameters is a significant prognostic factor for major adverse events. That shows patients with high postoperative mPAP and right atrium right and left diameter should be followed up closely.

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“…Medical therapies that target the underlying pulmonary microvascular disease can offer symptomatic and hemodynamic benefits, although they do not deal with the core mechanism of the disease which require the removal of thromboembolic material from pulmonary vasculature. Recent research has provided evidence suggesting balloon pulmonary angioplasty (BPA) is one treatment option for inoperable CTEPH and recurrent/persistent pulmonary hypertension after PEA [ 4 ]. Thrombolysis and surgical embolectomy may not be the cure for everyone, especially in case of repeated PEs [ 3 , 4 ].…”

mentioning

confidence: 99%

“…Recent research has provided evidence suggesting balloon pulmonary angioplasty (BPA) is one treatment option for inoperable CTEPH and recurrent/persistent pulmonary hypertension after PEA [ 4 ]. Thrombolysis and surgical embolectomy may not be the cure for everyone, especially in case of repeated PEs [ 3 , 4 ]. A clear step-by-step approach needs to be implemented in case of failed thrombolysis.…”

mentioning

confidence: 99%

Endarterectomy treatment for patients suffering from a new episode of pulmonary embolism, after screening for chronic thromboembolic pulmonary hypertension

et al. 2022

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Advances in treatment of chronic thromboembolic pulmonary hypertension

Cited by 6 publications

References 84 publications

Safety and efficacy of balloon pulmonary angioplasty for technically operable chronic thromboembolic pulmonary hypertension

Safety and efficacy of balloon pulmonary angioplasty for technically operable chronic thromboembolic pulmonary hypertension

Long-term Outcomes and Predictors of Chronic Thromboembolic Pulmonary Hypertension After Pulmonary Endarterectomy

Endarterectomy treatment for patients suffering from a new episode of pulmonary embolism, after screening for chronic thromboembolic pulmonary hypertension

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