Abstract:
The current treatment algorithm for chronic thromboembolic pulmonary hypertension (CTEPH) as depicted in the 2022 European Society of Cardiology (ESC)/European Respiratory Society (ERS) guidelines on the diagnosis and treatment of pulmonary hypertension (PH) includes a multimodal approach of combinations of pulmonary endarterectomy (PEA), balloon pulmonary angioplasty (BPA) and medical therapies to target major vessel pulmonary vascular lesions, and microvasculopathy. Today, BPA of >1700 patients has been reported in the literature from centers in Asia, the US, and also Europe; many more patients have been treated outside literature reports. As BPA becomes part of routine care of patients with CTEPH, benchmarks for safe and effective care delivery become increasingly important. In light of this development, the ESC Working Group on Pulmonary Circulation and Right Ventricular Function has decided to publish a document that helps standardize BPA to meet the need of uniformity in patient selection, procedural planning, technical approach, materials and devices, treatment goals, complications including their management, and patient follow-up, thus complementing the guidelines. Delphi methodology was utilized for statements that were not evidence based. First, an anatomical nomenclature and a description of vascular lesions are provided. Second, treatment goals and definitions of complete BPA are outlined. Third, definitions of complications are presented which may be the basis for a standardized reporting in studies involving BPA. The document is intended to serve as a companion to the official ESC/ERS guidelines.
摘要:
2022年欧洲心脏病学会(ESC)/欧洲呼吸学会(ERS)肺动脉高压(PH)诊断和治疗指南中描述的慢性血栓栓塞性肺动脉高压(CTEPH)的当前治疗算法包括多模式方法联合肺动脉内膜切除术(PEA),球囊肺血管成形术(BPA)和针对主要血管肺血管病变的药物治疗,和微血管病变。今天,在来自亚洲中心的文献中已经报道了超过1700名患者的BPA。美国,还有欧洲;更多的患者在文献报道之外接受了治疗。由于BPA成为CTEPH患者常规护理的一部分,安全有效的护理基准变得越来越重要。鉴于这一发展,ESC肺循环和右心室功能工作组已决定发布一份文件,以帮助标准化BPA,以满足患者选择的一致性需要。程序规划,技术方法,材料和设备,治疗目标,并发症,包括他们的管理,和患者随访,从而补充准则。德尔菲法用于非循证陈述。首先,提供了解剖学命名法和血管病变的描述。第二,概述了完全BPA的治疗目标和定义。第三,提出了并发症的定义,这可能是涉及BPA的研究中标准化报告的基础。该文件旨在作为ESC/ERS官方指南的配套文件。