Satoh Toru, Kataoka Masaharu, Inami Takumi, Ishiguro Haruhisa, Yanagisawa Ryoji, Shimura Nobuhiko, Shigeta Yohei, Yoshino Hideaki
a Division of Cardiology, Department of Medicine , Kyorin University School of Medicine , Tokyo , Japan.
b Division of Cardiology, Department of Medicine , Keio University School of Medicine , Tokyo , Japan.
Expert Rev Cardiovasc Ther. 2016 Sep;14(9):1089-94. doi: 10.1080/14779072.2016.1208083. Epub 2016 Jul 20.
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.
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.
经皮腔内肺动脉血管成形术（PTPA）于20世纪末被引入用于治疗慢性血栓栓塞性肺动脉高压（CTEPH），2001年首次在集体患者中尝试，取得了有益效果，但并发症数量适中。该技术在2010年左右得到改进，最近已被确立为一种有效且安全的治疗方法。
其适应症最初是伴有外周病变的无法手术的CTEPH，但现在已扩大到有症状或缺氧的患者。病变通常是机化血栓的网状结构，有时在血管造影上看不到狭窄，因此需要其他检查手段，如测量远端压力。治疗病变的技术与冠状动脉血管成形术相同，但有几点不同。专家评论：PTPA的效果与外科动脉内膜切除术相当，再灌注肺水肿和血管损伤等并发症现在可通过多种策略并基于经验加以控制。
