Efficacy and Safety of Guide Extension Catheter in Balloon Pulmonary Angioplasty for Treatment of Complex Lesions in Chronic Thromboembolic Pulmonary Hypertension

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2023 Jan 27

PMID 36706099

Authors

Masao Takigami

Naohiko Nakanishi

Hideo Tsubata

Kuniyoshi Fukai

Yuki Matsubara

Kenji Yanishi

Kan Zen

Takeshi Nakamura

Satoaki Matoba

Affiliations

Soon will be listed here.

Abstract

Background: Balloon pulmonary angioplasty (BPA) is used for treatment of inoperable chronic thromboembolic pulmonary hypertension (CTEPH) and residual pulmonary hypertension after pulmonary endarterectomy (PEA) to improve hemodynamics, right ventricular function, and exercise capacity. However, the effectiveness and safety of guide extension catheters for BPA treatment in patients with CTEPH have not been demonstrated.

Methods: We retrospectively analyzed 91 lesions in 55 sessions of 28 patients with CTEPH who underwent BPA using a guide extension catheter. The purpose (backup, coaxial, and extension), efficacy, and safety of the guide extension catheters were explored. The efficacy of the guide extension catheter was assessed based on the success of the procedures and safety was evaluated based on procedure-related complications.

Results: Regarding the intended use, a guide extension catheter was used to strengthen the backup force of the guiding catheter in 52% of cases, extend the tip of the catheter in 38% of cases, and maintain the coaxiality of the guiding catheter in 10% of cases. Procedural success was achieved in 92.7% of 55 sessions and in 95.6% of 91 lesions. Complex lesions had a lower success rate than simple lesions (p = 0.04). Regarding safety concerns, complications were observed in 5 of 55 sessions (9.1%) and 6 of 91 lesions (6.6%). Only one case of pulmonary artery dissection using a guide extension catheter was reported. Except for this one case, extension catheter-related complications were not observed.

Conclusions: A guide extension catheter can be used safely in BPA procedures with anatomically complex pulmonary artery branches and complex lesions by increasing backup support.

Citing Articles

"Guidezilla" extension catheter combined with balloon technique for treating pulmonary artery stenosis caused by Takayasu arteritis.

Wu Y, Wang J, Fu Z, Liu M, Xie W, Tao X J Interv Med. 2024; 6(4):199-202.

PMID: 38312129 PMC: 10831387. DOI: 10.1016/j.jimed.2023.10.003.

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