From the Department of Medicine, Cardiology Division, New York Medical College, Westchester Medical Center, Valhalla, NY.
Cardiol Rev. 2021;29(3):115-119. doi: 10.1097/CRD.0000000000000300.
Peripheral pulmonary artery stenosis (PAS) is an abnormal narrowing of the pulmonary vasculature and can form anywhere within the pulmonary artery tree. PAS is a congenital or an acquired disease, and its severity depends on the etiology, location, and number of stenoses. Most often seen in infants and young children, some symptoms include shortness of breath, fatigue, and tachycardia. Symptoms can progressively worsen over time as right ventricular pressure increases, leading to further complications including pulmonary artery hypertension and systolic and diastolic dysfunctions. The current treatment options for PAS include simple balloon angioplasty, cutting balloon angioplasty, and stent placement. Simple balloon angioplasty is the most basic therapeutic option for proximally located PAS. Cutting balloon angioplasty is utilized for more dilation-resistant PAS vessels and for more distally located PAS. Stent placement is the most effective option seen to treat the majority of PAS; however, it requires multiple re-interventions for serial dilations and is generally reserved for PAS vessels that are resistant to angioplasty.
周围性肺动脉狭窄(PAS)是肺血管的异常狭窄,可发生在肺动脉树的任何部位。PAS 可分为先天性或获得性,其严重程度取决于病因、位置和狭窄数量。最常见于婴儿和幼儿,一些症状包括呼吸急促、疲劳和心动过速。随着右心室压力的增加,症状会逐渐恶化,导致进一步的并发症,包括肺动脉高压和收缩及舒张功能障碍。目前 PAS 的治疗选择包括单纯球囊血管成形术、切割球囊血管成形术和支架置入术。单纯球囊血管成形术是治疗近端 PAS 最基本的治疗选择。切割球囊血管成形术用于更具扩张阻力的 PAS 血管和更远处的 PAS。支架置入术是治疗大多数 PAS 最有效的选择;然而,它需要多次再介入进行连续扩张,一般保留用于对血管成形术有抵抗的 PAS 血管。