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Open AccessCase Report

Balloon Pulmonary Angioplasty with Stent Implantation as a Treatment of Proximal Chronic Thromboembolic Pulmonary Hypertension

1
Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, Fryderyk Chopin Hospital in European Health Center Otwock, 05-400 Otwock, Poland
2
Department of Radiography, Medical University of Lublin, 20-081 Lublin, Poland
3
1st Chair and Department of Cardiology, Medical University of Warsaw, 02-087 Warsaw, Poland
4
Department of Radiology, European Health Center Otwock, 05-400 Otwock, Poland
*
Author to whom correspondence should be addressed.
Diagnostics 2020, 10(6), 363; https://doi.org/10.3390/diagnostics10060363
Received: 5 May 2020 / Revised: 25 May 2020 / Accepted: 27 May 2020 / Published: 1 June 2020
(This article belongs to the Special Issue Pulmonary Hypertension: Diagnosis and Management)
We present a case of a 67-year-old female with proximal chronic thromboembolic pulmonary hypertension (CTEPH), disqualified from pulmonary endarterectomy due to multiple comorbidities and high risk-to-benefit ratio as assessed by multidisciplinary CTEPH team. She was referred for balloon pulmonary angioplasty (BPA) and underwent three sessions with balloon catheters up to 8 mm diameter. During the second procedure, the elastic recoil phenomenon was observed in the treated post-thrombotic lesion of the right lower lobe artery, which made the balloon angioplasty ineffective. It was decided to implant a self-expanding stent for the prevention of restenosis. The procedure resulted in significant improvement of regional perfusion, as confirmed by control angiography. We feel that it contributed to the significant improvement of hemodynamic parameters and exercise capacity, as assessed three months after the last BPA procedure. In conclusion, pulmonary artery stenting may be an option in proximal CTEPH when elastic recoil phenomenon makes balloon angioplasty of a large vessel ineffective. View Full-Text
Keywords: chronic thromboembolic pulmonary hypertension; balloon pulmonary angioplasty; stent implantation chronic thromboembolic pulmonary hypertension; balloon pulmonary angioplasty; stent implantation
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Darocha, S.; Pietura, R.; Banaszkiewicz, M.; Pietrasik, A.; Kownacki, Ł.; Torbicki, A.; Kurzyna, M. Balloon Pulmonary Angioplasty with Stent Implantation as a Treatment of Proximal Chronic Thromboembolic Pulmonary Hypertension. Diagnostics 2020, 10, 363.

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