title: Percutaneous transluminal pulmonary angioplasty for the treatment of chronic thromboembolic pulmonary hypertension.
abstract: BACKGROUND
  Chronic thromboembolic pulmonary hypertension leads to pulmonary hypertension and right-sided heart failure. The purpose of this study was to investigate the efficacy of percutaneous transluminal pulmonary angioplasty (PTPA) for the treatment of chronic thromboembolic pulmonary hypertension.
  
  
  RESULTS
  Twenty-nine patients with chronic thromboembolic pulmonary hypertension underwent PTPA. One patient had a wiring perforation as a complication of PTPA and died 2 days after the procedure. In the remaining 28 patients, PTPA did not produce immediate hemodynamic improvement at the time of the procedure. However, after follow-up (6.0 ± 6.9 months), New York Heart Association functional classifications and levels of plasma B-type natriuretic peptide significantly improved (both P<0.01). Hemodynamic parameters also significantly improved (mean pulmonary arterial pressure, 45.3 ± 9.8 versus 31.8 ± 10.0 mm Hg; cardiac output, 3.6 ± 1.2 versus 4.6 ± 1.7 L/min, baseline versus follow-up, respectively; both P<0.01). Twenty-seven of 51 procedures in total (53%), and 19 of 28 first procedures (68%), had reperfusion pulmonary edema as the chief complication. Patients with severe clinical signs and/or severe hemodynamics at baseline had a high risk of reperfusion pulmonary edema.
  
  
  CONCLUSIONS
  PTPA improved subjective symptoms and objective variables, including pulmonary hemodynamics. PTPA may be a promising therapeutic strategy for the treatment of chronic thromboembolic pulmonary hypertension.
  
  
  BACKGROUND
  URL: http://www.umin.ac.jp. Unique identifier: UMIN000001572.
authors.affiliation: Division of Cardiology, Department of Medicine, Kyorin University School of Medicine, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Kataoka
authors.forename: Takumi
authors.initials: T
authors.lastname: Inami
authors.forename: Kentaro
authors.initials: K
authors.lastname: Hayashida
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Shimura
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Ishiguro
authors.forename: Takayuki
authors.initials: T
authors.lastname: Abe
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Tamura
authors.forename: Motomi
authors.initials: M
authors.lastname: Ando
authors.forename: Keiichi
authors.initials: K
authors.lastname: Fukuda
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yoshino
authors.forename: Toru
authors.initials: T
authors.lastname: Satoh
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000401:mortality; D062186:Arterial Pressure; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D065627:Familial Primary Pulmonary Hypertension; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D007564:Japan; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011654:Pulmonary Edema / Q000209:etiology; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D020127:Recovery of Function; D015427:Reperfusion Injury / Q000209:etiology; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain