title: Endovascular treatment for chronic pulmonary hypertension: a focus on angioplasty for chronic thromboembolic pulmonary hypertension.
abstract: BACKGROUND
  Percutaneous transluminal pulmonary angioplasty (PTPA) was introduced for the treatment of chronic thromboembolic pulmonary hypertension (CTEPH) in the late 20(th) century, and first attempts in collective patients were made in 2001 with beneficial effects but a moderate amount of complications. It was refined around 2010, and has been recently established as an effective and safe treatment.
  
  
  METHODS
  The indication was originally inoperable CTEPH with peripheral lesions, but has now widened to symptomatic or hypoxic patients. The lesion is typically a meshwork-like structure of organized thrombi and is sometimes not seen as a stenosis angiographically, necessitating other means of investigation such as measurement of distal pressure. The technique to treat lesions is the same as for coronary angioplasty except in several ways. Expert commentary: The effects of PTPA are comparable to those of surgical endarterectomy, and the complications of reperfusion pulmonary edema and vascular injury are now controlled by several strategies and based on experience.
authors.affiliation: a Division of Cardiology, Department of Medicine , Kyorin University School of Medicine , Tokyo , Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Satoh
authors.affiliation: b Division of Cardiology, Department of Medicine , Keio University School of Medicine , Tokyo , Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Kataoka
authors.affiliation: a Division of Cardiology, Department of Medicine , Kyorin University School of Medicine , Tokyo , Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Inami
authors.affiliation: a Division of Cardiology, Department of Medicine , Kyorin University School of Medicine , Tokyo , Japan.
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Ishiguro
authors.affiliation: a Division of Cardiology, Department of Medicine , Kyorin University School of Medicine , Tokyo , Japan.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Yanagisawa
authors.affiliation: a Division of Cardiology, Department of Medicine , Kyorin University School of Medicine , Tokyo , Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Shimura
authors.affiliation: a Division of Cardiology, Department of Medicine , Kyorin University School of Medicine , Tokyo , Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Shigeta
authors.affiliation: a Division of Cardiology, Department of Medicine , Kyorin University School of Medicine , Tokyo , Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yoshino
mesh_terms: D000792:Angiography / Q000379:methods; D000800:Angioplasty, Balloon / Q000379:methods*; D002908:Chronic Disease; D004691:Endarterectomy / Q000379:methods; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology / Q000628:therapy*; D011655:Pulmonary Embolism / Q000628:therapy*
keywords: Balloon pulmonary angioplasty; chronic thromboembolic pulmonary hypertension; percutaneous transluminal pulmonary angioplasty; pressure wire; pulmonary edema; pulmonary endarterectomy; pulmonary injury; pulmonary stenosis