TY - JOUR
T1 - An overview of balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension
AU - Kuronuma, Keiichiro
AU - Shimokawahara, Hiroto
AU - Matsubara, Hiromi
N1 - Publisher Copyright:
© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2025
Y1 - 2025
N2 - Introduction: Chronic thromboembolic pulmonary hypertension (CTEPH) is a severe and progressive condition caused by unresolved pulmonary arterial obstructions, leading to secondary microvasculopathy and poor hemodynamics. Pulmonary endarterectomy (PEA) is the first-line treatment for operable patients. Balloon pulmonary angioplasty (BPA) has emerged as a promising treatment option for patients considered inoperable due to distal lesions, comorbidities, or residual pulmonary hypertension (PH) after PEA. Following the development of the BPA in safety and efficacy, it has been widely adopted and utilized across the globe. Areas covered: This review covers the historical development of BPA, its clinical role, and technical methodologies. Medical therapies as an adjunctive role in CTEPH management are also discussed. Finally, we present recent BPA experiences from our institution, highlighting hemodynamic outcomes and survival rates. Expert opinion: BPA is a transformative treatment for patients with CTEPH, particularly those ineligible for PEA. Procedural refinements have significantly improved safety and efficacy. However, challenges remain, including the standardization of decision-making processes for management and the establishment of optimal treatment goals. Ongoing research continues to refine the role of BPA to improve outcomes and enhance the quality of life for patients with CTEPH. (Figure presented.).
AB - Introduction: Chronic thromboembolic pulmonary hypertension (CTEPH) is a severe and progressive condition caused by unresolved pulmonary arterial obstructions, leading to secondary microvasculopathy and poor hemodynamics. Pulmonary endarterectomy (PEA) is the first-line treatment for operable patients. Balloon pulmonary angioplasty (BPA) has emerged as a promising treatment option for patients considered inoperable due to distal lesions, comorbidities, or residual pulmonary hypertension (PH) after PEA. Following the development of the BPA in safety and efficacy, it has been widely adopted and utilized across the globe. Areas covered: This review covers the historical development of BPA, its clinical role, and technical methodologies. Medical therapies as an adjunctive role in CTEPH management are also discussed. Finally, we present recent BPA experiences from our institution, highlighting hemodynamic outcomes and survival rates. Expert opinion: BPA is a transformative treatment for patients with CTEPH, particularly those ineligible for PEA. Procedural refinements have significantly improved safety and efficacy. However, challenges remain, including the standardization of decision-making processes for management and the establishment of optimal treatment goals. Ongoing research continues to refine the role of BPA to improve outcomes and enhance the quality of life for patients with CTEPH. (Figure presented.).
KW - Balloon pulmonary angioplasty
KW - chronic thromboembolic pulmonary hypertension
KW - combination therapy
KW - pulmonary endarterectomy
KW - pulmonary hypertension targeted medications
UR - http://www.scopus.com/inward/record.url?scp=105003220552&partnerID=8YFLogxK
U2 - 10.1080/17476348.2025.2491721
DO - 10.1080/17476348.2025.2491721
M3 - Review article
C2 - 40227136
AN - SCOPUS:105003220552
SN - 1747-6348
VL - 19
SP - 563
EP - 573
JO - Expert Review of Respiratory Medicine
JF - Expert Review of Respiratory Medicine
IS - 6
ER -