Balloon Pulmonary Angioplasty Effective for Treatment of CTEPH Patients Unable to Undergo Surgery

Old blood clots in lung arteries can impede blood flow, resulting in pressure accumulation in the affected arteries. This can cause symptoms such as shortness of breath, fatigue, chest pain, and fainting spells, significantly impacting one's quality of life. Chronic thromboembolic pulmonary hypertension (CTEPH) is the condition that arises from these blockages and is often addressed with open-heart surgery. However, many CTEPH patients are unable to undergo surgery due to other health complications or inaccessible artery blockages. Now, a new study has demonstrated that a novel treatment called balloon pulmonary angioplasty can effectively treat CTEPH patients who are not candidates for surgery.

The study, carried out by researchers at the Lewis Katz School of Medicine at Temple University (Philadelphia, PA, USA) was among the largest investigations of balloon pulmonary angioplasty in the U.S. till now. The study revealed that clearing blockages in lung arteries substantially improved exercise capacity and quality of life for these patients. Moreover, CTEPH patients who received balloon pulmonary angioplasty treatment experienced reduced symptoms, and some could even discontinue medications.

Introduced in the early 2000s, balloon pulmonary angioplasty initially had high major complication rates. However, over the past decade, technique advancements have significantly enhanced its effectiveness and safety. The procedure involves inserting a small tube into the groin vein, followed by advancing a long catheter over a wire into the lung arteries. A blockage is then identified using an X-ray camera, and a small balloon is employed to gradually open the blockage while simultaneously monitoring blood pressure. Patients typically remain awake, receiving mild sedation and local anesthesia.

Balloon pulmonary angioplasty requires multiple treatment sessions to open blockages throughout the lungs. The approach used at Temple is gradual and methodical to minimize complications, particularly lung bleeding. Temple is among the leading US centers for treating CTEPH patients with balloon pulmonary angioplasty. Although balloon pulmonary angioplasty has traditionally been associated with high bleeding risk, continued procedural refinement has successfully lowered bleeding rates in patients treated at Temple.

“In doing so, we are now able to show that balloon pulmonary angioplasty is not only relatively safe but also associated with key improvements in pulmonary hypertension and functional capacity,” said Riyaz Bashir, MD, FACC, Professor of Medicine and Director of Vascular and Endovascular Medicine in the Section of Cardiology, Department of Medicine, at the Lewis Katz School of Medicine and Temple University Hospital, and senior investigator on the new study.

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