Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH) is a progressive condition characterized
by persistent thromboembolic disease in the pulmonary arteries, leading to increased
pulmonary vascular resistance and right heart failure. Medical therapy offers symptomatic
relief but is not curative. Pulmonary thromboendarterectomy (PTE) remains the gold
standard treatment; however, patients are often ineligible for surgery due to unfavorable
anatomy, comorbidities, or preferences.
Balloon pulmonary angioplasty (BPA) has emerged as a minimally invasive alternative,
particularly for patients with inoperable CTEPH or post-PTE patients who remain symptomatic.
Balloon catheters are used to dilate stenotic pulmonary arteries and to disrupt intraluminal
webs and synechia, improving hemodynamics and leading to better quality of life. Careful
patient selection for BPA is crucial, requiring a multidisciplinary approach to identify
suitable candidates. Although BPA has demonstrated favorable outcomes, challenges
remain in optimizing procedural techniques, reducing complication rates, and establishing
standardized treatment protocols.
This work aims to review BPA and its role in treating CTEPH, from patient selection
to expected outcomes, as well as potential areas of future research, which includes
the need for increased awareness and accessibility to specialized CTEPH centers, advancements
in imaging technology, procedural standardization, and investigation of combination
therapies to further support BPA efficacy and improve patient outcomes.
Keywords
balloon pulmonary angioplasty - chronic thromboembolic pulmonary hypertension - pulmonary
embolism - interventional radiology - angioplasty
