Catheter Interventions for Pulmonary Artery Stenosis

Treatment of Peripheral Pulmonary Artery Stenosis

“…In addition to the more accurate incision at more distal and less accessible locations, this technique could decrease traumatic vessel injury such as intimal flap formation and vessel wall dissection. 10,14 This could then reduce the potential unintended complications such as those seen with simple balloon angioplasty. There were also some initial speculations that CB angioplasty could lower the rate of restenosis by decreasing the proliferative response.…”

“…[36][37][38] By 2014, with over 20 studies that had tested the efficacy of stent placement for PAS, this treatment method was shown to have an exceptionally high successful dilation rate of 90% on average, with some studies showing a 100% success rate. 10,14,[39][40][41][42] These stents could then significantly improve the PA pressure gradient, RV pressure, and pulmonary perfusion. There is also evidence of hemodynamic success nicely translating to clinical success, measured as improved ventilator efficiency, aerobic capacity, and symptoms.…”

“…Predictive risk factors for restenosis have been studied, but the only risk factor understood to be associated to restenosis is increased weight of the patient at follow-up. 5,10,21 No risk factors related to the procedural or hemodynamic characteristics of the patients have yet been identified.…”

“…Acquired PAS is most often seen in patients following cardiac surgery to repair or improve congenitally malformed hearts. 2,10,11 Several procedures have been shown to lead to the development of PAS, including shunt placement, an arterial switch operation, pulmonary artery band placement, or aortic arch augmentation. Postoperative patients have an increased risk of unintended scar formation along the PA vasculature, twisting of the PA vessels, or external compression of the vessel.…”

Possible effects of left pulmonary artery stenting in single ventricle patients on bronchial area, lung volume and lung function

“…Stenosis of the central pulmonary arteries is frequent and leads to an obstruction and imbalance of pulmonary blood flow (4,5). The left pulmonary artery (LPA) is mainly affected, as it may be compressed by the dilated (neo-)ascending aorta, or be hypoplastic due to a reduced blood flow (6)(7)(8). In these cases, the treatment of choice is percutaneous stent implantation, since it is minimally invasive, and the radial force of the stent permits to overcome external vessel compression (6,7).…”