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首页> 外文期刊>European respiratory review >Balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension
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Balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension

机译：慢性血栓栓塞性肺动脉高压的球囊肺血管成形术

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Chronic thromboembolic pulmonary hypertension (CTEPH) is thought to result from incomplete resolution of pulmonary thromboemboli that undergo organisation into fibrous tissue within pulmonary arterial branches; filling pulmonary arterial lumina with collagenous obstructions. The treatment of choice is pulmonary endarterectomy (PEA) in CTEPH centres; which has low post-operative mortality and good long-term survival. For patients ineligible for PEA or who have recurrent or persistent pulmonary hypertension after surgery; medical treatment with riociguat is beneficial. In addition; percutaneous balloon pulmonary angioplasty (BPA) is an emerging option; and promises haemodynamic and functional benefits for inoperable patients. In contrast to conventional angioplasty; BPA with undersized balloons over guide wires exclusively breaks intraluminal webs and bands; without dissecting medial vessel layers; and repeat sessions are generally required. Observational studies report that BPA improves haemodynamics; symptoms and functional capacity in patients with CTEPH; but controlled trials with long-term follow-up are needed. Complications include haemoptysis; wire injury; vessel dissection; vessel rupture; reperfusion pulmonary oedema; pulmonary parenchymal bleeding and haemorrhagic pleural effusions. This review summarises the available evidence for BPA; patient selection; recent technical refinements and periprocedural imaging; and discusses the potential future role of BPA in the management of CTEPH.
机译：慢性血栓栓塞性肺动脉高压（CTEPH）被认为是由于肺血栓栓塞的消解不完全所致，肺动脉血栓栓塞经过组织进入肺动脉分支内的纤维组织。用胶原蛋白阻塞物填充肺动脉腔。选择的治疗方法是在CTEPH中心进行肺动脉内膜切除术（PEA）;术后死亡率低，长期生存率高。对于不符合PEA资格或术后复发或持续性肺动脉高压的患者; riociguat的药物治疗是有益的。此外;经皮球囊肺血管成形术（BPA）是新兴的选择;并为无法手术的患者带来血液动力学和功能方面的益处。与常规血管成形术相反; BPA的导丝上的气球尺寸过小，只能破坏管腔内的网和带。不解剖内侧血管层;并且通常需要重复会话。观察性研究报告说，双酚A改善了血流动力学。 CTEPH患者的症状和功能能力;但需要长期随访的对照试验。并发症包括咯血;电线受伤;血管夹层;血管破裂;再灌注肺水肿;肺实质出血和出血性胸腔积液。这篇综述总结了双酚A的现有证据;患者选择;最近的技术改进和过程外成像;并讨论了BPA在CTEPH管理中的潜在未来作用。

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