Bilateral versus unilateral balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension
Abstract Background To evaluate the safety and efficacy of bilateral balloon pulmonary angioplasty (BPA) as compared with unilateral BPA for patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). Method We reviewed 210 consecutive BPA sessions for 92 CTEPH patients, includin...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | Respiratory Research |
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| Online Access: | https://doi.org/10.1186/s12931-022-02017-6 |
| _version_ | 1828789075963805696 |
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| author | Cheng Hong Jianmin Lu Xiaofeng Wu Wenliang Guo Jielong Lin Riken Chen Haimin Liu Haiming Chen Yongxia Lei Jian Wang Yue Zhong Chunying Zhuang Xinlu Wang |
| author_facet | Cheng Hong Jianmin Lu Xiaofeng Wu Wenliang Guo Jielong Lin Riken Chen Haimin Liu Haiming Chen Yongxia Lei Jian Wang Yue Zhong Chunying Zhuang Xinlu Wang |
| author_sort | Cheng Hong |
| collection | DOAJ |
| description | Abstract Background To evaluate the safety and efficacy of bilateral balloon pulmonary angioplasty (BPA) as compared with unilateral BPA for patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). Method We reviewed 210 consecutive BPA sessions for 92 CTEPH patients, including 124 unilateral BPA sessions and 86 bilateral BPA sessions. Radiation exposure, operation details, lesions characteristics and the occurrence of complications were compared between unilateral BPA and bilateral BPA. 131 BPA sessions with a hemodynamics follow-up were included for efficacy analysis, in which hemodynamics changes were compared. Logistic regression analysis was used to identify factors associated with the occurrence of complications. Result Bilateral BPA treated more lobes, arteries and lesions [3 (2, 4) vs. 2 (1, 3) lobes, p < 0.001; 8 (5.5, 10) vs. 6 (4, 8) vessels, p = 0.003; 9 (7, 12) vs. 8 (5, 10) lesions, p = 0.01] in one single session than unilateral BPA in a comparable operation duration and amount of contrast media given. Overall, the occurrence of complications was similar between bilateral BPA and unilateral BPA [9 (10.5%) vs. 12 (9.7%), p = 0.83]. Hemodynamics effects didn’t differ significantly between bilateral BPA and unilateral BPA in a single session [mPAP, − 4.5 ± 8.6 vs. − 3.6 ± 7.3 mmHg, p = 0.52; PVR, − 1.1 (− 3.5, 0.8) vs. − 1.8 (− 5.2, 0.3) Wood units, p = 0.21]. For the initial BPA session, bilateral BPA also treated more lobes, arteries and lesions than unilateral BPA [3 (2, 4) vs. 2 (1, 2) lobes, p < 0.001; 8.0 (5.8, 9.3) vs. 6.0 (4.0, 8.0) vessels, p = 0.04; 9 (6, 12) vs. 7 (4, 10) lesions, p = 0.02]. The occurrence of complications was also similar [5 (13.2%) vs. 5 (9.3%), p = 0.80], even in patients with poor baseline hemodynamics. Univariate regression analysis reveals the number of lobes treated/session, but not bilateral BPA, as predictive factors of complications. Conclusion Bilateral BPA may be safely and effectively performed in patients with CTEPH without increasing operation duration and radiation burden, even in patients with unfavorable baseline hemodynamics. |
| first_indexed | 2024-12-12T01:04:33Z |
| format | Article |
| id | doaj.art-a5606bad178a4e03b8c0f2bd1b460264 |
| institution | Directory Open Access Journal |
| issn | 1465-993X |
| language | English |
| last_indexed | 2024-12-12T01:04:33Z |
| publishDate | 2022-05-01 |
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| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-a5606bad178a4e03b8c0f2bd1b4602642022-12-22T00:43:37ZengBMCRespiratory Research1465-993X2022-05-0123111210.1186/s12931-022-02017-6Bilateral versus unilateral balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertensionCheng Hong0Jianmin Lu1Xiaofeng Wu2Wenliang Guo3Jielong Lin4Riken Chen5Haimin Liu6Haiming Chen7Yongxia Lei8Jian Wang9Yue Zhong10Chunying Zhuang11Xinlu Wang12State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical UniversityState Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical UniversityState Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical UniversityState Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Guangzhou Medical UniversityState Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical UniversityState Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical UniversityState Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Guangzhou Medical UniversityState Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical UniversityState Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical UniversityGuangzhou Medical UniversityState Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical UniversityAbstract Background To evaluate the safety and efficacy of bilateral balloon pulmonary angioplasty (BPA) as compared with unilateral BPA for patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). Method We reviewed 210 consecutive BPA sessions for 92 CTEPH patients, including 124 unilateral BPA sessions and 86 bilateral BPA sessions. Radiation exposure, operation details, lesions characteristics and the occurrence of complications were compared between unilateral BPA and bilateral BPA. 131 BPA sessions with a hemodynamics follow-up were included for efficacy analysis, in which hemodynamics changes were compared. Logistic regression analysis was used to identify factors associated with the occurrence of complications. Result Bilateral BPA treated more lobes, arteries and lesions [3 (2, 4) vs. 2 (1, 3) lobes, p < 0.001; 8 (5.5, 10) vs. 6 (4, 8) vessels, p = 0.003; 9 (7, 12) vs. 8 (5, 10) lesions, p = 0.01] in one single session than unilateral BPA in a comparable operation duration and amount of contrast media given. Overall, the occurrence of complications was similar between bilateral BPA and unilateral BPA [9 (10.5%) vs. 12 (9.7%), p = 0.83]. Hemodynamics effects didn’t differ significantly between bilateral BPA and unilateral BPA in a single session [mPAP, − 4.5 ± 8.6 vs. − 3.6 ± 7.3 mmHg, p = 0.52; PVR, − 1.1 (− 3.5, 0.8) vs. − 1.8 (− 5.2, 0.3) Wood units, p = 0.21]. For the initial BPA session, bilateral BPA also treated more lobes, arteries and lesions than unilateral BPA [3 (2, 4) vs. 2 (1, 2) lobes, p < 0.001; 8.0 (5.8, 9.3) vs. 6.0 (4.0, 8.0) vessels, p = 0.04; 9 (6, 12) vs. 7 (4, 10) lesions, p = 0.02]. The occurrence of complications was also similar [5 (13.2%) vs. 5 (9.3%), p = 0.80], even in patients with poor baseline hemodynamics. Univariate regression analysis reveals the number of lobes treated/session, but not bilateral BPA, as predictive factors of complications. Conclusion Bilateral BPA may be safely and effectively performed in patients with CTEPH without increasing operation duration and radiation burden, even in patients with unfavorable baseline hemodynamics.https://doi.org/10.1186/s12931-022-02017-6Chronic thromboembolic pulmonary hypertensionBalloon pulmonary angioplastyComplicationTreatment |
| spellingShingle | Cheng Hong Jianmin Lu Xiaofeng Wu Wenliang Guo Jielong Lin Riken Chen Haimin Liu Haiming Chen Yongxia Lei Jian Wang Yue Zhong Chunying Zhuang Xinlu Wang Bilateral versus unilateral balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension Respiratory Research Chronic thromboembolic pulmonary hypertension Balloon pulmonary angioplasty Complication Treatment |
| title | Bilateral versus unilateral balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension |
| title_full | Bilateral versus unilateral balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension |
| title_fullStr | Bilateral versus unilateral balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension |
| title_full_unstemmed | Bilateral versus unilateral balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension |
| title_short | Bilateral versus unilateral balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension |
| title_sort | bilateral versus unilateral balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension |
| topic | Chronic thromboembolic pulmonary hypertension Balloon pulmonary angioplasty Complication Treatment |
| url | https://doi.org/10.1186/s12931-022-02017-6 |
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