Karyofyllis Panagiotis, Demerouti Eftychia, Papadopoulou Varvara, Voudris Vassilis, Matsubara Hiromi
Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Sygrou Ave 356, Kallithea, 17674, Athens, Greece.
Department of Clinical Science and Department of Cardiology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 7011192, Japan.
Curr Treat Options Cardiovasc Med. 2020 Feb 13;22(3):7. doi: 10.1007/s11936-020-0807-3.
Chronic thromboembolic pulmonary hypertension (CTEPH) is a major cause of precapillary pulmonary hypertension leading to right heart failure and death if left untreated. In addition to pulmonary endarterectomy, which is considered the standard of care, and specific drug therapy that is not however expected to offer relief from the mechanical component of the disease, the therapeutic options for CTEPH have expanded with the development of balloon pulmonary angioplasty (BPA). The purpose of this review is a better understanding and evaluation of BPA as a treatment option in CTEPH patients.
With the evolution of BPA almost all over the world, more centers outside Japan, which remains the leader for the technique, presented their results confirming the efficacy, safety, and feasibility of this procedure as a complementary strategy in the treatment algorithm of CTEPH. Summarizing, more data from all over the world confirm that BPA is a challenging but potentially effective intervention for the treatment of inoperable CTEPH patients. However, there is a need for standardization of the technique, and furthermore, large, international, multicenter randomized controlled trials comparing BPA with the other treatment modalities of CTEPH are imperative.
慢性血栓栓塞性肺动脉高压（CTEPH）是毛细血管前性肺动脉高压的主要病因，若不治疗可导致右心衰竭和死亡。除了被视为标准治疗方法的肺动脉内膜剥脱术，以及虽无法缓解疾病机械性因素但有特定药物治疗外，随着球囊肺动脉成形术（BPA）的发展，CTEPH的治疗选择有所增加。本综述的目的是更好地理解和评估BPA作为CTEPH患者的一种治疗选择。
随着BPA在全球的发展，除日本外（日本仍是该技术的领先者），更多中心公布了其结果，证实了该手术作为CTEPH治疗方案中一种补充策略的有效性、安全性和可行性。综上所述，来自世界各地的更多数据证实，BPA对无法手术的CTEPH患者来说是一种具有挑战性但可能有效的干预措施。然而，该技术需要标准化，此外，开展大型国际多中心随机对照试验，将BPA与CTEPH的其他治疗方式进行比较势在必行。
