Complications of Balloon Pulmonary Angioplasty: A Comprehensive Analysis Based on the Latest ESC Consensus Statement

Overview

Journal J Clin Med

Specialty General Medicine

Date 2024 Aug 10

PMID 39124580

Authors

Fe J van Leusden

Diederik P Staal

Mitch C J van Thor

Benno J M W Rensing

Jan-Peter Van Kuijk

Berend M Mulder

Daniel A F van den Heuvel

Sanne Boerman

Karin A Boomars

Joyce Peper

Johannes J Mager

Marco C Post

Affiliations

Soon will be listed here.

Abstract

The literature reports high complication rates in patients with chronic thromboembolic pulmonary hypertension (CTEPH) who undergo balloon pulmonary angioplasty (BPA), especially in patients with poor pulmonary hemodynamics. Here, we describe the complications of BPA based on the new definitions. All patients with CTEPH who completed BPA treatment before 15 September 2023 were selected from the CTEPH database. Peri-procedural complications were collected and classified according to the 2023 consensus paper on BPA treatment. Complications were analyzed in subgroups of patients with pulmonary vascular resistance (PVR), ≤ or >6.6 WU, and mean pulmonary artery pressure (mPAP), ≤ or >45 mmHg, at first BPA. In this analysis, 87 patients (63% women; mean age 61.1 ± 14.0 years; 62% on dual PH targeted medical therapy) underwent 426 (mean 4.9 ± 1.6 per patient) BPAs. Only non-severe complications occurred in 14% of BPA treatments and in 47% of the patients; 31% patients had a thoracic complication. The thoracic complications were mild (71%) or moderate (29%). Patients with a PVR > 6.6 WU ( = 8) underwent more BPA treatments (6.6 ± 1.5 versus 4.6 ± 1.5, = 0.002), had more complications (88% versus 41% of patients, = 0.020), and had more thoracic complications (17% vs. 7% of BPAs, = 0.013) than patients with PVR ≤ 6.6 WU. Patients with mPAP > 45 mmHg ( = 13) also had more BPA treatments (6.5 ± 1.7 versus 4.6 ± 1.4, < 0.001), more complications (77% versus 44% of patients, = 0.027) and more thoracic complications (14% versus 8% of BPAs, = 0.039) than patients with mPAP ≤ 45 mmHg. Complications occurred in 14% of BPAs and were mostly mild. Patients with severe pulmonary hemodynamics suffered more (thoracic) complications.

Citing Articles

Optimizing Medical Pretreatment for Balloon Pulmonary Angioplasty: Overshoot or Stride Toward Optimal Multimodal Treatment.

Staal D, van Leusden F, van Thor M, Peper J, Rensing B, van Kuijk J Pulm Circ. 2025; 15(1):e70028.

PMID: 39830170 PMC: 11739795. DOI: 10.1002/pul2.70028.

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