PMID- 28034568 OWN - NLM STAT- MEDLINE DCOM- 20170602 LR - 20220410 IS - 1872-7727 (Electronic) IS - 0720-048X (Linking) VI - 89 DP - 2017 Apr TI - Efficacy and safety of balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension guided by cone-beam computed tomography and electrocardiogram-gated area detector computed tomography. PG - 270-276 LID - S0720-048X(16)30407-7 [pii] LID - 10.1016/j.ejrad.2016.12.013 [doi] AB - BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease characterized by chronic obstructive thrombus and pulmonary hypertension. Balloon pulmonary angioplasty (BPA), an emerging alternative catheter-based treatment for inoperable patients with CTEPH, has not yet been standardised, especially for lesion assessment in distal pulmonary arteries. Recent advancement in computed tomography enables distal CTEPH lesions to be visualized. METHODS: We retrospectively studied 80 consecutive patients with inoperable CTEPH who received BPA guided by cone-beam computed tomography (CT) (CBCT) or electrocardiogram (ECG)-gated area detector CT (ADCT) for target lesion assessment. We collected clinical and hemodynamic data, including procedural complications, before BPA and at 3 months and 1year after BPA. RESULTS: Three hundred eight-five BPA sessions (4.8 sessions/patient) were performed for the lesions of subsegmental arteries (1155 lesions), segmental arteries (738 lesions), and lobar arteries (4 lesions) identified by CBCT or ECG-gated ADCT. Significant improvements in the symptoms, 6-min walk distance, brain natriuretic peptide level, exercise capacity, and haemodynamics were observed 3 months and 1year after BPA. No cases of death or cardiogenic shock with a low rate of severe wire perforation (0.3%) and severe reperfusion oedema (0.3%) were observed. CONCLUSIONS: BPA guided by CBCT or ECG-gated ADCT is effective and remarkably safe in patients with CTEPH . These new advanced CT techniques may be useful in pre-BPA target lesion assessment. CI - Copyright (c) 2016 Elsevier Ireland Ltd. All rights reserved. FAU - Ogo, Takeshi AU - Ogo T AD - Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan; Department of Advanced Mediccal Research for Pulmonary Hypertension, National Cerebral and Cardiovascular Centre, Osaka, Japan. Electronic address: ogo.takeshi.hp@mail.ncvc.go.jp. FAU - Fukuda, Tetsuya AU - Fukuda T AD - Department of Radiology, National Cerebral and Cardiovascular Centre, Osaka, Japan. FAU - Tsuji, Akihiro AU - Tsuji A AD - Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan. FAU - Fukui, Shigefumi AU - Fukui S AD - Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan. FAU - Ueda, Jin AU - Ueda J AD - Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan. FAU - Sanda, Yoshihiro AU - Sanda Y AD - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan. FAU - Morita, Yoshiaki AU - Morita Y AD - Department of Radiology, National Cerebral and Cardiovascular Centre, Osaka, Japan. FAU - Asano, Ryotaro AU - Asano R AD - Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan. FAU - Konagai, Nao AU - Konagai N AD - Division of Pulmonary Circulation, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan. FAU - Yasuda, Satoshi AU - Yasuda S AD - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan. LA - eng PT - Journal Article DEP - 20161221 PL - Ireland TA - Eur J Radiol JT - European journal of radiology JID - 8106411 SB - IM MH - Aged MH - Angioplasty, Balloon/*methods MH - Chronic Disease MH - Cone-Beam Computed Tomography/methods MH - Electrocardiography MH - Female MH - Hemodynamics/physiology MH - Humans MH - Hypertension, Pulmonary/diagnostic imaging/physiopathology/*therapy MH - Male MH - Middle Aged MH - Pulmonary Artery/diagnostic imaging MH - Pulmonary Embolism/diagnostic imaging/physiopathology/*therapy MH - Retrospective Studies MH - Surgery, Computer-Assisted/methods MH - Thromboembolism/diagnostic imaging/physiopathology/*therapy MH - Thrombosis/diagnostic imaging/etiology/physiopathology MH - Tomography, X-Ray Computed/methods OTO - NOTNLM OT - Balloon pulmonary angioplasty OT - Chronic thromboembolic pulmonary hypertension OT - Cone-beam computed tomography OT - ECG-gated area detector computed tomography EDAT- 2016/12/31 06:00 MHDA- 2017/06/03 06:00 CRDT- 2016/12/31 06:00 PHST- 2016/09/15 00:00 [received] PHST- 2016/11/16 00:00 [revised] PHST- 2016/12/15 00:00 [accepted] PHST- 2016/12/31 06:00 [pubmed] PHST- 2017/06/03 06:00 [medline] PHST- 2016/12/31 06:00 [entrez] AID - S0720-048X(16)30407-7 [pii] AID - 10.1016/j.ejrad.2016.12.013 [doi] PST - ppublish SO - Eur J Radiol. 2017 Apr;89:270-276. doi: 10.1016/j.ejrad.2016.12.013. Epub 2016 Dec 21.