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Multicenter Study
. 2022 Jan 28;17(13):1104-1111.
doi: 10.4244/EIJ-D-21-00230.

Balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension: a multicentre registry

Szymon Darocha  1 , Marek Roik  2 , Grzegorz Kopeć  3 , Aleksander Araszkiewicz  4 , Michał Furdal  5 , Maciej Lewandowski  6 , Wojciech Jacheć  7 , Marek Grabka  8 , Marta Banaszkiewicz  1 , Arkadiusz Pietrasik  9 , Radosław Pietura  10 , Jakub Stępniewski  3   11 , Marcin Waligóra  3   11 , Wojciech Magoń  3 , Kamil Jonas  3   11 , Andrzej Łabyk  2 , Michał Potępa  2 , Aleksandra Fudryna  2 , Stanisław Jankiewicz  4 , Sylwia Sławek-Szmyt  4 , Tatiana Mularek-Kubzdela  4 , Maciej Lesiak  4 , Ewa Mroczek  5 , Joanna Orłowska  5 , Małgorzata Peregud-Pogorzelska  6 , Andrzej Tomasik  7 , Katarzyna Mizia-Stec  8 , Roman Przybylski  12 , Piotr Podolec  3 , Dariusz Zieliński  13 , Andrzej Biederman  13 , Adam Torbicki  1 , Piotr Pruszczyk  2 , Marcin Kurzyna  1
Affiliations
Multicenter Study

Balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension: a multicentre registry

Szymon Darocha et al. EuroIntervention. .

Abstract

Background: Balloon pulmonary angioplasty (BPA) is a promising therapy for patients with chronic thromboembolic pulmonary hypertension (CTEPH) who are ineligible for pulmonary endarterectomy.

Aims: The present study aimed to evaluate the safety and efficacy of BPA for CTEPH using the first multicentre registry of a single European country.

Methods: Data were obtained from the Database of Pulmonary Hypertension in the Polish Population (NCT03959748), a prospective, multicentre registry of adult and paediatric pulmonary arterial hypertension (PAH) and CTEPH, for a total of 236 patients with confirmed CTEPH (124 women; mean age 67 years) who underwent 1,056 BPA procedures at eight institutions in Poland.

Results: In 156 patients who underwent follow-up assessments after a median of 5.9 (IQR: 3.0-8.0) months after final BPA, the mean pulmonary arterial pressure decreased from 45.1±10.7 to 30.2±10.2 mmHg (p<0.001) and pulmonary vascular resistance from 642±341 to 324±183 dynes (p<0.001), and the six-minute walking test (6MWT) improved from 341±129 to 423±136 m (p<0.001). Pulmonary injury related to the BPA procedure occurred in 6.4% of all sessions. Eighteen patients (7.6%) died during follow-up, including 4 (1.7%) who died within 30 days after BPA. Overall survival was 92.4% (95% confidence interval [CI]: 87.6%-94.9%) three years after the initial BPA procedure.

Conclusions: This multicentre registry confirmed significant improvement of haemodynamic, functional, and biochemical parameters after BPA. Complication rates were low and overall survival comparable to the results of another registry. Therefore, BPA may be an important therapeutic option in patients with CTEPH in Poland.

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Conflict of interest statement

S. Darocha and G. Kopeć have received grants and personal fees from Janssen-Cilag, MSD, Bayer, and AOP Orphan. K. Jonas has received grants and personal fees from Janssen-Cilag and MSD. A. Araszkiewicz has received grants and personal fees from MSD and Bayer. A. Torbicki has received speaker’s and consultancy honoraria from Janssen-Cilag, Bayer and MSD. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1. Long-term survival after balloon pulmonary angioplasty (BPA).
A) Survival from the initial BPA procedure in all registered patients (n=236). B) Survival from the last BPA procedure in patients for whom BPA was terminated (n=156).
See this image and copyright information in PMC

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