PMID- 18559220
OWN - NLM
STAT- MEDLINE
DCOM- 20081103
LR  - 20190917
IS  - 0300-2896 (Print)
IS  - 0300-2896 (Linking)
VI  - 44
IP  - 6
DP  - 2008 Jun
TI  - [Image-guided minimally invasive treatment of pulmonary arterial hypertension due 
      to embolic disease].
PG  - 312-7
AB  - OBJECTIVE: Although surgical pulmonary thromboendarterectomy is the treatment of 
      choice for pulmonary hypertension due to chronic thrombotic and/or embolic 
      disease, minimally invasive endovascular techniques such as angioplasty or 
      placement of a metallic stent can provide acceptable results when surgery is not 
      indicated or has been refused by the patient. PATIENTS AND METHODS: Eight 
      patients (5 men, 3 women; mean age, 62.6 years) were treated. The patients were 
      in New York Heart Association (NYHA) class III or IV and had a mean pulmonary 
      artery pressure of 40 mm Hg and more, a capillary wedge pressure of 15 mm Hg or 
      less, or a Miller index greater than 0.5. In all cases, diagnosis was based on 
      Doppler echocardiography, pulmonary angiography, hemodynamic evaluation, and 
      ventilation-perfusion scintigraphy. All patients received fibrinolytic therapy 
      and underwent angioplasty. A metallic stent was implanted in 3 patients. 
      Follow-up echocardiographic assessment and ventilation-perfusion scans were 
      scheduled at 1, 3, 6, and 12 months. RESULTS: The procedures were technically 
      successful in all cases. The mean follow-up period was 18.7 months. Minor 
      complications were extrasystoles (3 cases), slight bruising at the site of 
      puncture (1 case), and rectal bleeding that resolved without treatment (1 case). 
      One patient died from an unknown cause 24 hours after the procedure. In all other 
      cases, improvements were noted in NYHA functional class, in hemodynamics 
      demonstrated by echocardiography, and in vascular structure as shown by 
      arteriography and scintigraphy. CONCLUSIONS: Minimally invasive endovascular 
      interventions can help improve pulmonary arterial hypertension due to chronic 
      thrombotic and/or embolic disease in patients for whom medical or surgical 
      treatment is not possible.
FAU - de Gregorio, Miguel Angel
AU  - de Gregorio MA
AD  - Unidad de Cirugia Minimamente Invasiva Guiada por Imagen, Hospital Clinico 
      Universitario Lozano Blesa, Zaragoza, Spain. mgregori@unizar.es
FAU - Laborda, Alicia
AU  - Laborda A
FAU - Ortas, Rosario
AU  - Ortas R
FAU - Higuera, Teresa
AU  - Higuera T
FAU - Gomez-Arrue, Javier
AU  - Gomez-Arrue J
FAU - Medrano, Joaquin
AU  - Medrano J
FAU - Mainar, Antonio
AU  - Mainar A
LA  - spa
PT  - English Abstract
PT  - Journal Article
TT  - Tratamiento de la hipertension arterial pulmonar postembolica mediante tecnicas 
      minimamente invasivas guiadas por imagen.
PL  - Spain
TA  - Arch Bronconeumol
JT  - Archivos de bronconeumologia
JID - 0354720
SB  - IM
MH  - Aged
MH  - *Angioplasty
MH  - Diagnostic Imaging
MH  - Female
MH  - Humans
MH  - Hypertension, Pulmonary/diagnosis/*etiology/*surgery
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Pulmonary Embolism/*complications
MH  - *Stents
EDAT- 2008/06/19 09:00
MHDA- 2008/11/04 09:00
CRDT- 2008/06/19 09:00
PHST- 2008/06/19 09:00 [pubmed]
PHST- 2008/11/04 09:00 [medline]
PHST- 2008/06/19 09:00 [entrez]
AID - S0300-2896(08)70438-1 [pii]
AID - 10.1016/s1579-2129(08)60051-8 [doi]
PST - ppublish
SO  - Arch Bronconeumol. 2008 Jun;44(6):312-7. doi: 10.1016/s1579-2129(08)60051-8.