J Cardiovasc Interv.  2023 Oct;2(4):209-219. 10.54912/jci.2023.0007.

Balloon Pulmonary Angioplasty: Paradigm Shift in Chronic Thromboembolic Pulmonary Hypertension (CTEPH)

• Ahn CM

• KMID: 2560947
• DOI: http://doi.org/10.54912/jci.2023.0007

Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare and deteriorating condition defined as chronic obstruction of pulmonary artery with organized thrombi which causes pulmonary hypertension, and this disease entity classified as group 4 pulmonary hypertension. It usually happens within the first 2 years after the event of symptomatic pulmonary thromboembolism (PTE), however, there are frequent cases associated without previous history of PTE. Because of poor functional status, co-morbidities and chronicity of disease, conventional curative strategy of open pulmonary endarterectomy (PEA) cannot be applicable up to half of CTEPH patients. Another obstacle for operative approach would be lesion accessibility especially involved distal segmental and subsegmental pulmonary artery. In addition to the unrecectable condition, there needs also for bridging therapy in case of technically operable with unacceptable medical condition for general anesthesia or residual symptomatic pulmonary hypertension following PEA. Recently, in addition to innovation of medical therapy, balloon pulmonary angioplasty for patients with CTEPH introduced as Class Ib strategy for inoperable condition in ESC guideline. In this article, recent advances and prospectives regarding as interventional approach for patients with CTEPH.

Keyword

Pulmonary embolism; Angioplasty, pulmonary