Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension

Abstract

Balloon pulmonary angioplasty (BPA) is a rapidly emerging and developing therapy for inoperable chronic thromboembolic pulmonary hypertension (CTEPH). BPA is associated with improvements in functional and hemodynamic status, imaging indices of right ventricular performance, and survival. However, BPA should only be undertaken at a CTEPH referral center with pulmonary thromboendarterectomy capability, and only after multidisciplinary discussion determines the patient is a poor candidate for pulmonary endarterectomy. Meticulous attention to procedural technique is critical to ensure procedural success and to limit the risk of complications. Randomized controlled trials are also needed to further refine BPA’s role in comprehensive CTEPH care. Nonetheless, BPA is an increasingly effective and safe therapy for CTEPH that is associated with clinical improvements and is rapidly becoming a cornerstone of referral center CTEPH care.