Significance and operation points of balloon pulmonary angioplasty in the treatment of chronic thromboembolic pulmonary hypertension
-
摘要: 慢性血栓栓塞性肺高压的病理机制为肺动脉内的纤维化血栓阻塞血管，影响血流动力学，完成血运重建是其治疗的关键，肺动脉球囊扩张成形术是肺动脉段以下血运重建的重要方法。本文主要介绍肺动脉球囊扩张成形术的临床意义、常见并发症，并结合本中心经验对其技术要点和临床管理进行阐述。
-
关键词:
- 慢性血栓栓塞性肺高压 /
- 肺动脉球囊扩张成形术 /
- 经皮肺动脉球囊成形术
Abstract: The pathological mechanism of chronic thromboembolic pulmonary hypertension is that the fibrosis-thrombus in the pulmonary artery obstructs blood vessels and affects hemodynamics. Revascularization is the key treatment. Balloon pulmonary angioplasty(BPA) is the main method for revascularization below the pulmonary artery segment. This paper mainly introduces the clinical significance and common complications of BPA, and expounds the operation points and clinical management of BPA combined with the experience of our center. -
-
图 3 尝试开通上叶闭塞的肺动脉
Figure 3. The occluded pulmonary artery in the upper lobe was tried to open
图 4 使用球囊进出病变碎裂血栓
Figure 4. The thrombus was fragmented by using the balloon to enter and exit the lesion
-
[1] Humbert M, Kovacs G, Hoeper MM, et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension[J]. Eur Heart J, 2022, 43(38): 3618-3731. doi: 10.1093/eurheartj/ehac237
[2] Delcroix M, Torbicki A, Gopalan D, et al. ERS statement on chronic thromboembolic pulmonary hypertension[J]. Eur Respir J, 2021, 57(6): 2002828. doi: 10.1183/13993003.02828-2020
[3] Leber L, Beaudet A, Muller A, et al. Epidemiology of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: identification of the most accurate estimates from a systematic literature review[J]. Pulm Circ, 2021, 11(1): 2045894020977300.
[4] Kitani M, Ogawa A, Sarashina T, et al. Histological changes of pulmonary arteries treated by balloon pulmonary angioplasty in a patient with chronic thromboembolic pulmonary hypertension[J]. Circ Cardiovasc Interv, 2014, 7(6): 857-859. doi: 10.1161/CIRCINTERVENTIONS.114.001533
[5] Voorburg JA, Cats VM, Buis B, et al. Balloon angioplasty in the treatment of pulmonary hypertension caused by pulmonary embolism[J]. Chest, 1988, 94(6): 1249-1253. doi: 10.1378/chest.94.6.1249
[6] Feinstein JA, Goldhaber SZ, Lock JE, et al. Balloon pulmonary angioplasty for treatment of chronic thromboembolic pulmonary hypertension[J]. Circulation, 2001, 103(1): 10-13. doi: 10.1161/01.CIR.103.1.10
[7] Inami T, Kataoka M, Shimura N, et al. Pulmonary edema predictive scoring index(PEPSI), a new index to predict risk of reperfusion pulmonary edema and improvement of hemodynamics in percutaneous transluminal pulmonary angioplasty[J]. JACC Cardiovasc Interv, 2013, 6(7): 725-736. doi: 10.1016/j.jcin.2013.03.009
[8] Mizoguchi H, Ogawa A, Munemasa M, et al. Refined balloon pulmonary angioplasty for inoperable patients with chronic thromboembolic pulmonary hypertension[J]. Circ Cardiovasc Interv, 2012, 5(6): 748-755. doi: 10.1161/CIRCINTERVENTIONS.112.971077
[9] Aoki T, Sugimura K, Tatebe S, et al. Comprehensive evaluation of the effectiveness and safety of balloon pulmonary angioplasty for inoperable chronic thrombo-embolic pulmonary hypertension: long-term effects and procedure-related complications[J]. Eur Heart J, 2017, 38(42): 3152-3159. doi: 10.1093/eurheartj/ehx530
[10] Kwon W, Yang JH, Park TK, et al. Impact of balloon pulmonary angioplasty on hemodynamics and clinical outcomes in patients with chronic thromboembolic pulmonary hypertension: the initial Korean experience[J]. J Korean Med Sci, 2018, 33(4): e24. doi: 10.3346/jkms.2018.33.e24
[11] Ogawa A, Satoh T, Fukuda T, et al. Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension: results of a multicenter registry[J]. Circ Cardiovasc Qual Outcomes, 2017, 10(11): e004029. doi: 10.1161/CIRCOUTCOMES.117.004029
[12] Ishiguro H, Kataoka M, Inami T, et al. Diversity of lesion morphology in CTEPH analyzed by OCT, pressure wire, and angiography[J]. JACC Cardiovasc Imaging, 2016, 9(3): 324-325. doi: 10.1016/j.jcmg.2015.02.015
[13] Jiang X, Zhu YJ, Zhou YP, et al. Clinical features and survival in Takayasu's arteritis-associated pulmonary hypertension: a nationwide study[J]. Eur Heart J, 2021, 42(42): 4298-4305. doi: 10.1093/eurheartj/ehab599
[14] Delcroix M, Lang I, Pepke-Zaba J, et al. Long-term outcome of patients with chronic thromboembolic pulmonary hypertension: results from an international prospective registry[J]. Circulation, 2016, 133(9): 859-871.
-
下载:
图(5)
计量
- 文章访问数: 1861
- PDF下载数: 1010
- 施引文献: 0