Survival Predictors in Pulmonary Arterial Hypertension Patients Undergoing Balloon Pulmonary Angioplasty
DOI:
https://doi.org/10.70749/ijbr.v3i4.1213Keywords:
Chronic Thromboembolic Pulmonary Hypertension, Balloon Pulmonary Angioplasty, Pulmonary Arterial Hypertension, Survival Predictors, HemodynamicsAbstract
Introduction: Chronic thromboembolic pulmonary hypertension (CTEPH) is a severe complication of pulmonary embolism that leads to progressive right heart failure and death if untreated. Balloon pulmonary angioplasty (BPA) has emerged as a promising intervention for patients with inoperable or residual disease post-pulmonary endarterectomy. Objective: To identify predictors of short-term survival in pulmonary arterial hypertension patients undergoing BPA. Materials and Method: This prospective observational study was conducted at Department of Cardiology, Hayatabad Medical Complex, Peshawar from January, 2023 to June 2023. Fifty-two patients with confirmed inoperable or residual CTEPH underwent BPA. Hemodynamic and clinical parameters were assessed pre- and post-procedure, and survival was evaluated at six months. Results: Survival at six months was 88.5%. Post-procedural mean pulmonary artery pressure <35 mmHg, baseline cardiac index ≥2.0 L/min/m², and absence of vascular injury during BPA were independent predictors of survival. Significant improvements were observed in mPAP, PVR, and WHO functional class. Conclusion: BPA significantly improves survival and clinical status in selected PAH patients. Early hemodynamic response and procedural safety are key survival predictors.
Downloads
References
Ito, R., Yamashita, J., Ikeda, S., Nakajima, Y., Kasahara, T., Sasaki, Y., Suzuki, S., Takahashi, L., Komatsu, I., Murata, N. and Shimahara, Y., 2023. Predictors of procedural complications in balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension. Journal of Cardiology, 82(6), pp.497-503.
https://doi.org/10.1016/j.jjcc.2023.06.011
Piliero, N., Thony, F., Guillien, A., Rousseau, J., Finas, M., Vautrin, E., Degano, B. and Bouvaist, H., 2022. Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension: evaluation of haemodynamic effects, complication rates and radiation exposure over time. Archives of cardiovascular diseases, 115(5), pp.295-304.
https://doi.org/10.1016/j.acvd.2022.02.010
Kennedy, M.K., Kennedy, S.A., Tan, K.T., de Perrot, M., Bassett, P., McInnis, M.C., Thenganatt, J., Donahoe, L., Granton, J. and Mafeld, S., 2023. Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension: a systematic review and meta-analysis. Cardiovascular and interventional radiology, 46(1), pp.5-18.
https://doi.org/10.1007/s00270-022-03323-8
Li, X., Zhang, Y., Jin, Q., Luo, Q., Zhao, Q., Yang, T., Zeng, Q., Yan, L., Duan, A., Huang, Z. and Hu, M., 2022. Predictors of early response to balloon pulmonary angioplasty in patients with inoperable chronic thromboembolic pulmonary hypertension. Therapeutic Advances in Respiratory Disease, 16, p.17534666221138001.
https://doi.org/10.1177/17534666221138001
Yang, K.M., Wang, M.T., Tao, C.W., Wu, Y.J., Hsu, C.H., Liao, W.C., Hsu, H.H., Lin, M.C., Tsai, F.T., Fu, Y.J. and Kuo, F.Y., 2024. The long-term outcome of chronic thromboembolic pulmonary hypertension: Pulmonary endarterectomy and balloon pulmonary angioplasty. Journal of the Chinese Medical Association, 87(3), pp.273-279.
https://doi.org/10.1097/jcma.0000000000001059
Daigo, K., Katsumata, Y., Esaki, K., Iwasawa, Y., Ichihara, G., Miura, K., Shirakawa, K., Sato, Y., Sato, K. and Fukuda, K., 2023. Predictors of improvement in exercise tolerance after balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension. Journal of the American Heart Association, 12(3), p.e8137.
https://doi.org/10.1161/jaha.122.027395
Xin, L., Zhang, Y., Luo, Q., Zhao, Q., Yang, T., Zeng, Q., Jin, Q., Duan, A., Huang, Z., Hu, M. and Zhang, S., 2023. Development and validation of a nomogram for predicting hemodynamic response to balloon pulmonary angioplasty in patients with chronic thromboembolic pulmonary hypertension. Respiratory Medicine, 220, p.107440.
https://doi.org/10.1016/j.rmed.2023.107440
Darocha, S., Roik, M., Kopeć, G., Araszkiewicz, A., Furdal, M., Lewandowski, M., Jacheć, W., Grabka, M., Banaszkiewicz, M., Pietrasik, A. and Pietura, R., 2022. Balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension: a multicentre registry. EuroIntervention, 17(13), p.1104.
https://doi.org/10.4244/eij-d-21-00230
Ejiri, K., Ogawa, A., Shimokawahara, H. and Matsubara, H., 2022. Treatment of vascular injury during balloon pulmonary angioplasty in patients with chronic thromboembolic pulmonary hypertension. JACC: Asia, 2(7), pp.831-842.
https://doi.org/10.1016/j.jacasi.2022.08.011
Taniguchi, Y., Matsuoka, Y., Onishi, H., Yanaka, K., Emoto, N., Nakai, H., Okada, K. and Hirata, K., 2021. The role of balloon pulmonary angioplasty and pulmonary endarterectomy: Is chronic thromboembolic pulmonary hypertension still a life-threatening disease?. International Journal of Cardiology, 326, pp.170-177.
https://doi.org/10.1016/j.ijcard.2020.10.026
Delcroix, M., Pepke-Zaba, J., D’Armini, A.M., Fadel, E., Guth, S., Hoole, S.P., Jenkins, D.P., Kiely, D.G., Kim, N.H., Madani, M.M. and Matsubara, H., 2024. Worldwide CTEPH registry: long-term outcomes with pulmonary endarterectomy, balloon pulmonary angioplasty, and medical therapy. Circulation, 150(17), pp.1354-1365.
https://doi.org/10.1161/circulationaha.124.068610
Mahmud, E., Patel, M., Ang, L. and Poch, D., 2021. Advances in balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension. Pulmonary Circulation, 11(2), p.20458940211007385.
https://doi.org/10.1177/20458940211007385
Kallonen, J., Korsholm, K., Bredin, F., Corbascio, M., Jønsson Andersen, M., Ilkjær, L.B., Mellemkjær, S. and Sartipy, U., 2022. Association of residual pulmonary hypertension with survival after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Pulmonary Circulation, 12(2), p.e12093.
https://doi.org/10.1002/pul2.12093
Masaki, K., Hosokawa, K., Funakoshi, K., Taniguchi, Y., Adachi, S., Inami, T., Yamashita, J., Ogino, H., Tsujino, I., Hatano, M. and Yaoita, N., 2024. Outcomes of chronic thromboembolic pulmonary hypertension after balloon pulmonary angioplasty and pulmonary endarterectomy. JACC: Asia, 4(8), pp.577-589.
https://doi.org/10.1016/j.jacasi.2024.05.007
Fujii, S., Nagayoshi, S., Ogawa, K., Muto, M., Tanaka, T.D., Minai, K., Kawai, M. and Yoshimura, M., 2021. A pilot cohort study assessing the feasibility of complete revascularization with balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension. PLoS One, 16(7), p.e0254770.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research

This work is licensed under a Creative Commons Attribution 4.0 International License.