Abstract/References

Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension:its history and development, and regional medical cooperation in Fukushima

Kazuhiko Nakazato, Koichi Sugimoto, Masayoshi Oikawa, Yasuchika Takeishi

Author information
  • Kazuhiko Nakazato
    Regional Medical Support Center, Fukushima Medical University
    Department of Cardiovascular Medicine, Fukushima Medical University
  • Koichi Sugimoto
    Department of Cardiovascular Medicine, Fukushima Medical University
    Futaba Emergency and General Medicine Support Center, Fukushima Medical University
  • Masayoshi Oikawa
    Department of Cardiovascular Medicine, Fukushima Medical University
  • Yasuchika Takeishi
    Department of Cardiovascular Medicine, Fukushima Medical University

Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) is designated as an intractable disease by the Ministry of Health, Labour and Welfare of Japan, and has an extremely poor prognosis if untreated. Surgical pulmonary endarterectomy is the curative treatment for cases in which the organized thrombi are located in the central part of the pulmonary artery, but there had been no effective treatment for cases in which the thrombi are located in the peripheral part of the pulmonary artery. Recently, balloon pulmonary angioplasty (BPA), a transcatheter procedure to dilate stenotic or occluded lesions in the peripheral pulmonary artery, has been rapidly developed. Although BPA was once a globally abandoned procedure due to hemorrhagic complications, Japanese experts have improved the technique, and its safety and efficacy have been enhanced. As a result, BPA is now being reevaluated worldwide. This review describes the history and development of BPA in the treatment of CTEPH, as well as the status of this treatment in Fukushima Prefecture.

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Figures

Ventilation-perfusion mismatch illustrated through scintigraphy images, showing distinct patterns for ventilation and perfusion.
Medical imaging showing vascular abnormalities, including total occlusion, subtotal occlusion, and ring-like stenosis.
Angiography image showing a web lesion in the right A5 artery, alongside an OCT finding for detailed analysis.
CT scan image of a human chest showing lung structures and airways.
3D visualization of bronchial structures in contrasting colors, showcasing the left and right lungs.
Medical imaging showing sub-occluded lesions in the right A8 artery, with dilation results from two sessions.
Graphs showing pre- and post-BPA measurements of mPA, PVR, and WHO functional class.
Map showing specialized clinics for pulmonary hypertension in Fukushima Prefecture, Japan, with locations marked for patients treated with BPA.
Table displaying major BPA reports on CTEPH worldwide, including authors, patient numbers, sessions, and survival rates.
Table of patients treated with BPA at Fukushima Medical University Hospital, including demographics and treatment details.

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