Pressure-Wire-Guided Percutaneous Transluminal Pulmonary Angioplasty

• Published in: JACC. Cardiovascular interventions 2014-11, Vol.7 (11), p.1297-1306
• Main Authors: Inami, Takumi, MD, Kataoka, Masaharu, MD, Shimura, Nobuhiko, MD, Ishiguro, Haruhisa, MD, Yanagisawa, Ryoji, MD, Fukuda, Keiichi, MD, Yoshino, Hideaki, MD, Satoh, Toru, MD
• Format: Article
• Language: English
• Subjects: Cardiovascular; chronic thromboembolic pulmonary hypertension; percutaneous transluminal pulmonary angioplasty; pressure wire; Pulmonary Edema Predictive Scoring Index; reperfusion pulmonary edema
• ISSN: 1936-8798; 1876-7605
• DOI: 10.1016/j.jcin.2014.06.010

Abstract Objectives This study sought to prove the safety and effectiveness of pressure-wire-guided percutaneous transluminal pulmonary angioplasty (PTPA). Background PTPA has been demonstrated to be effective for treatment of chronic thromboembolic pulmonary hypertension. However, a major and occasionally fatal complication after PTPA is reperfusion pulmonary edema. To avoid this, we developed the PEPSI (Pulmonary Edema Predictive Scoring Index). The pressure wire has been used to detect insufficiency of flow in a vessel. Methods We included 350 consecutive PTPA sessions in 103 patients with chronic thromboembolic pulmonary hypertension from January 1, 2009 to December 31, 2013. During these 5 years, 140 PTPA sessions were performed without guidance, 65 with guidance of PEPSI alone, and 145 with both PEPSI and pressure-wire guidance. Each PTPA session was finished after achieving PEPSI scores of