{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:06:42Z","timestamp":1791410802558,"version":"4.3.3"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>Although balloon pulmonary angioplasty (BPA) for inoperable patients with chronic thromboembolic pulmonary hypertension was first reported over a decade ago, its clinical application has been restricted because of limited efficacy and complications. We have refined the procedure of BPA to maximize its clinical efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>\n                      Sixty-eight consecutive patients with inoperable chronic thromboembolic pulmonary hypertension underwent BPA. We evaluated pulmonary artery diameters and determined the appropriate balloon size by using intravascular ultrasound. We performed BPA in a staged fashion over multiple, separate procedures to maximize efficacy and reduce the risk of reperfusion pulmonary injury. A total of 4 (2\u20138) sessions were performed in each patient, and the number of vessels dilated per session was 3 (1\u201314). The World Health Organization functional class improved from 3 to 2 (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.01), and mean pulmonary arterial pressure was decreased from 45.4\u00b19.6 to 24.0\u00b16.4 mm Hg (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.01). One patient died because of right heart failure 28 days after BPA. During follow-up for 2.2\u00b11.4 years after the final BPA, another patient died of pneumonia, and the remaining 66 patients are alive. In 57 patients who underwent right heart catheterization at follow-up, improvement of mean pulmonary arterial pressure was maintained (24.0\u00b15.8 mm Hg at 1.0\u00b10.9 years). Forty-one patients (60%) developed reperfusion pulmonary injury after BPA, but mechanical ventilation was required in only 4 patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>Our refined BPA procedure improves clinical status and hemodynamics of inoperable patients with chronic thromboembolic pulmonary hypertension, with a low mortality. A refined BPA procedure could be considered as a therapeutic approach for patients with inoperable chronic thromboembolic pulmonary hypertension.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circinterventions.112.971077","type":"journal-article","created":{"date-parts":[[2012,11,28]],"date-time":"2012-11-28T20:46:57Z","timestamp":1354135617000},"page":"748-755","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":550,"title":["Refined Balloon Pulmonary Angioplasty for Inoperable Patients with Chronic Thromboembolic Pulmonary Hypertension"],"prefix":"10.1161","volume":"5","author":[{"given":"Hiroki","family":"Mizoguchi","sequence":"first","affiliation":[{"name":"From the Division of Cardiology (H.Miz., M.M., H.Mik., H.Mat.) and Department of Clinical Science (A.O., H.Mat.), National Hospital Organization Okayama Medical Center, Okayama, Japan; Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan (H.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aiko","family":"Ogawa","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology (H.Miz., M.M., H.Mik., H.Mat.) and Department of Clinical Science (A.O., H.Mat.), National Hospital Organization Okayama Medical Center, Okayama, Japan; Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan (H.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuru","family":"Munemasa","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology (H.Miz., M.M., H.Mik., H.Mat.) and Department of Clinical Science (A.O., H.Mat.), National Hospital Organization Okayama Medical Center, Okayama, Japan; Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan (H.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Mikouchi","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology (H.Miz., M.M., H.Mik., H.Mat.) and Department of Clinical Science (A.O., H.Mat.), National Hospital Organization Okayama Medical Center, Okayama, Japan; Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan (H.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Ito","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology (H.Miz., M.M., H.Mik., H.Mat.) and Department of Clinical Science (A.O., H.Mat.), National Hospital Organization Okayama Medical Center, Okayama, Japan; Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan (H.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromi","family":"Matsubara","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology (H.Miz., M.M., H.Mik., H.Mat.) and Department of Clinical Science (A.O., H.Mat.), National Hospital Organization Okayama Medical Center, Okayama, Japan; Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan (H.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semtcvs.2006.09.008"},{"key":"e_1_3_2_3_2","first-page":"274","article-title":"Technique and outcomes of pulmonary endarterectomy surgery.","volume":"14","author":"Thistlethwaite PA","year":"2008","unstructured":"Thistlethwaite PA, Kaneko K, Madani MM, Jamieson SW. 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