Interventional Treatment Strategy for Different Types of Pulmonary Artery Lesions in Chronic Thromboembolic Pulmonary Hypertension
10.3969/j.issn.1000-3614.2025.02.013
- VernacularTitle:不同类型的慢性血栓栓塞性肺动脉高压肺血管病变的介入治疗策略
- Author:
Xin LI
1
;
Tao YANG
;
Yi ZHANG
;
Qin LUO
;
Qing ZHAO
;
Qixian ZENG
;
Sicheng ZHANG
;
Zhihui ZHAO
;
Zhihong LIU
Author Information
1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 呼吸与肺血管疾病诊治中心,北京 100037
- Publication Type:Journal Article
- Keywords:
pulmonary hypertension;
intervention;
chronic thromboembolic pulmonary hypertension;
balloon pulmonary angioplasty;
strategy
- From:
Chinese Circulation Journal
2025;40(2):190-196
- CountryChina
- Language:Chinese
-
Abstract:
Chronic thromboembolic pulmonary hypertension is characterised by the persistent obstruction of the proximal pulmonary arteries by organized thrombi and peripheral microvascular disease,which can lead to right-sided heart failure and mortality.Pulmonary endarterectomy enables complete removal of visible obstructive elements within the pulmonary arteries and is recommended for operable patients.Nevertheless,over 40%of patients are precluded from pulmonary endarterectomy because of factors such as surgically inaccessible lesions,compromised general health status,or concurrent comorbidities or still with residual pulmonary hypertension after pulmonary endarterectomy.For inoperable patients or those with residual pulmonary hypertension after pulmonary endarterectomy,balloon pulmonary angioplasty is an effective therapeutic option,which could significantly improve the hemodynamic,exercise tolerance and outcome of the patients.With the emerging accumulation of clinical experience and evidence,2022 European Society of Cardiology/European Respiratory Society guidelines of pulmonary hypertension recommend balloon pulmonary angioplasty as an alternative therapeutic option for these patients.However,different types of lesions may have their own lesion characteristics,the strategy and device of balloon pulmonary angioplasty should thus be individually considered for different lesions,in fact,the success rate of treatment and the incidence rate of complications are varied significantly.Therefore,the aim of this review is to comprehensively summarize the existing studies on balloon pulmonary angioplasty treatment strategies for different types of lesions and the management of complications to provide guidance and reference for clinicians.