Department of Cardiology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan.
Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Cardiovasc Interv Ther. 2023 Apr;38(2):231-240. doi: 10.1007/s12928-022-00866-y. Epub 2022 Jun 22.
Balloon pulmonary angioplasty (BPA) is now a treatment option for patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). However, the incidence of restenosis and long-term changes in vessel diameters in pulmonary arteries after BPA are unknown. The present study investigated the incidence of restenosis by measuring changes in vessel diameter after BPA. We reviewed 58 patients (168 lesions) with CTEPH who underwent single dilation for the target lesion (type A/B/C lesions) during BPA procedure followed by selective pulmonary angiography more than 6 months after the final BPA procedure. The outcomes of BPA were assessed in terms of pulmonary artery diameters. In a median follow-up of 1.9 (1.2-2.7) years, restenosis occurred in only one case with a type C lesion after BPA (0.6%). In type A/B lesions, the minimal lumen diameter was significantly enlarged at follow-up after BPA [3.48 (2.59-4.34) to 4.22 (3.31-4.90) mm]. In type C lesions, the minimal lumen diameter was unchanged at follow-up after BPA [3.15 (1.96-3.64) to 3.28 (2.38-4.61) mm]. The present results revealed that restenosis after BPA rarely occurs in type A/B/C lesions. Minimal lumen diameters for type A/B lesions continually increased and those for type C lesions did not decrease. Stent implantation in type A/B/C lesions would be unnecessary after BPA.
球囊肺动脉成形术（BPA）现在是治疗无法手术的慢性血栓栓塞性肺动脉高压（CTEPH）患者的一种选择。然而，BPA 后肺动脉直径的再狭窄发生率和长期变化尚不清楚。本研究通过测量 BPA 后血管直径的变化来研究再狭窄的发生率。我们回顾了 58 例（168 处病变）CTEPH 患者，这些患者在 BPA 过程中对目标病变（A/B/C 型病变）进行了单次扩张，然后在最后一次 BPA 后超过 6 个月进行了选择性肺动脉造影。BPA 的结果根据肺动脉直径进行评估。在中位数为 1.9 年（1.2-2.7 年）的随访中，只有一例 C 型病变的患者在 BPA 后发生再狭窄（0.6%）。在 A/B 型病变中，BPA 后随访时最小管腔直径明显增大[3.48（2.59-4.34）至 4.22（3.31-4.90）mm]。在 C 型病变中，BPA 后随访时最小管腔直径不变[3.15（1.96-3.64）至 3.28（2.38-4.61）mm]。本研究结果表明，BPA 后再狭窄很少发生在 A/B/C 型病变中。A/B 型病变的最小管腔直径持续增加，C 型病变的最小管腔直径没有减小。BPA 后无需在 A/B/C 型病变中植入支架。
