PMID- 36474104
OWN - NLM
STAT- MEDLINE
DCOM- 20230105
LR  - 20230111
IS  - 1432-086X (Electronic)
IS  - 0174-1551 (Linking)
VI  - 46
IP  - 1
DP  - 2023 Jan
TI  - Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension: 
      A Systematic Review and Meta-analysis.
PG  - 5-18
LID - 10.1007/s00270-022-03323-8 [doi]
AB  - PURPOSE: To perform a systematic review and meta-analysis assessing the safety 
      and efficacy of balloon pulmonary angioplasty (BPA) in the treatment of chronic 
      thromboembolic pulmonary hypertension (CTEPH). MATERIALS AND METHODS: Systematic 
      literature searches were performed from inception to June 2022 to identify 
      studies assessing BPA for CTEPH. Outcomes of interest included the following 
      functional and hemodynamic measures: (a) six-minute walk distance (6MWD), (b) New 
      York Heart Association (NYHA) status, (c) World Health Organization 
      (WHO)-Functional Class status, (d) cardiac index (CI), (e) mean pulmonary artery 
      pressure (mPAP), (f) mean right atrial pressure (mRAP), and (g) pulmonary 
      vascular resistance (PVR). Subgroup analysis was also performed for BPA in 
      post-pulmonary endarterectomy (PEA) patients. All reported BPA-related 
      complications were also recorded. Forty unique studies with a total of 1763 
      patients were identified for meta-analysis. RESULTS: All functional and 
      hemodynamic parameters improved significantly following BPA; 6MWD increased 70 m 
      (95% CI 58-82; P < 0.001), NYHA class improved by - 0.9 classes (95% CI - 1.0 to 
      - 0.8; P < 0.001), WHO-FC class improved by - 1 classes ((95% CI - 1.2 to - 0.9; 
      P < 0.001), CI increased 0.26 L/min/m(2) (95% CI 0.17-0.35; P < 0.001), mPAP 
      decreased - 13.2 mmHg (95% CI - 14.7 to - 11.8; P < 0.001), mRAP decreased 
      - 2.2 mmHg (95% CI - 2.8 to - 1.6; P < 0.001), and PVR decreased - 311 
      dyne/cm/s(-5) (95% CI - 350 to - 271; P < 0.001). Meta-analysis of patients who 
      underwent BPA for persistent pulmonary hypertension post-PEA demonstrated 
      significant improvements in 6MWD, WHO-FC, PVR and mPAP. Most common complications 
      included lung injury (8.16%), hemoptysis (7.07%) and vessel injury (5.05%). 
      CONCLUSION: BPA represents a safe and effective treatment option for select 
      individuals with CTEPH with significant improvements in hemodynamic parameters, 
      improved exercise tolerance and a relatively low risk of major complications.
CI  - (c) 2022. Springer Science+Business Media, LLC, part of Springer Nature and the 
      Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
FAU - Kennedy, Mary K
AU  - Kennedy MK
AD  - Department of Medical Imaging, University of Toronto, 200 Elizabeth St, Toronto, 
      ON, M5G 2C4, Canada.
FAU - Kennedy, Sean A
AU  - Kennedy SA
AD  - Department of Medical Imaging, University of Toronto, 200 Elizabeth St, Toronto, 
      ON, M5G 2C4, Canada. sean.kennedy@medportal.ca.
FAU - Tan, Kong Teng
AU  - Tan KT
AD  - Department of Medical Imaging, University of Toronto, 200 Elizabeth St, Toronto, 
      ON, M5G 2C4, Canada.
FAU - de Perrot, Marc
AU  - de Perrot M
AD  - Division of Thoracic Surgery, Department of Surgery, University of Toronto, 
      Toronto, ON, Canada.
FAU - Bassett, Paul
AU  - Bassett P
AD  - Statsconsultancy Ltd, Amersham, Buckinghamshire, UK.
FAU - McInnis, Michael C
AU  - McInnis MC
AD  - Department of Medical Imaging, University of Toronto, 200 Elizabeth St, Toronto, 
      ON, M5G 2C4, Canada.
FAU - Thenganatt, John
AU  - Thenganatt J
AD  - Division of Respirology, Department of Medicine, University of Toronto, Toronto, 
      ON, Canada.
FAU - Donahoe, Laura
AU  - Donahoe L
AD  - Statsconsultancy Ltd, Amersham, Buckinghamshire, UK.
FAU - Granton, John
AU  - Granton J
AD  - Division of Respirology, Department of Medicine, University of Toronto, Toronto, 
      ON, Canada.
FAU - Mafeld, Sebastian
AU  - Mafeld S
AD  - Department of Medical Imaging, University of Toronto, 200 Elizabeth St, Toronto, 
      ON, M5G 2C4, Canada.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20221206
PL  - United States
TA  - Cardiovasc Intervent Radiol
JT  - Cardiovascular and interventional radiology
JID - 8003538
SB  - IM
MH  - Humans
MH  - *Hypertension, Pulmonary/therapy/etiology
MH  - Pulmonary Artery
MH  - *Pulmonary Embolism/complications/therapy
MH  - Chronic Disease
MH  - *Angioplasty, Balloon/adverse effects
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Angioplasty
OT  - Chronic thromboembolic pulmonary hypertension
OT  - Pulmonary
EDAT- 2022/12/07 06:00
MHDA- 2023/01/06 06:00
CRDT- 2022/12/06 23:41
PHST- 2022/03/03 00:00 [received]
PHST- 2022/11/16 00:00 [accepted]
PHST- 2022/12/07 06:00 [pubmed]
PHST- 2023/01/06 06:00 [medline]
PHST- 2022/12/06 23:41 [entrez]
AID - 10.1007/s00270-022-03323-8 [pii]
AID - 10.1007/s00270-022-03323-8 [doi]
PST - ppublish
SO  - Cardiovasc Intervent Radiol. 2023 Jan;46(1):5-18. doi: 
      10.1007/s00270-022-03323-8. Epub 2022 Dec 6.