A Novel Technique of Balloon Pulmonary Angioplasty for the Treatment of Total Occlusion LesionsNovel Teaching Points
Shun Minatsuki, MD,
Arihiro Kiyosue, MD,
Yu Shimizu, MD,
Izumi Tanikawa,
Takahide Murasawa,
Kazutoshi Hirose, MD,
Akihito Saito, MD,
Hiroki Yagi, MD,
Norifumi Takeda, MD,
Masaru Hatano, MD,
Jiro Ando, MD,
Issei Komuro, MD
Affiliations
Shun Minatsuki, MD
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan; Corresponding author: Dr Shun Minatsuki, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Tel.: +1-81-33815-5411; fax: +1-81-35800-9082.
Arihiro Kiyosue, MD
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
Yu Shimizu, MD
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
Izumi Tanikawa
Department of Medical Engineering, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
Takahide Murasawa
Department of Medical Engineering, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
Kazutoshi Hirose, MD
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
Akihito Saito, MD
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
Hiroki Yagi, MD
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
Norifumi Takeda, MD
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
Masaru Hatano, MD
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
Jiro Ando, MD
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
Issei Komuro, MD
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
Balloon pulmonary angioplasty (BPA) has been recognized as an alternative therapeutic approach for patients with inoperative chronic thromboembolic pulmonary hypertension and those with residual pulmonary hypertension after pulmonary endarterectomy. However, the safe and successful treatment rate for a total occlusion lesion (TOL) using BPA is low, mainly because vessels distal to the occlusion are invisible by angiogram. Here, we present the case of a 53-year-old woman with chronic thromboembolic pulmonary hypertension with successfully recanalization of a TOL by use of BPA with the aid of intracardiac echocardiography. The intracardiac echocardiography–assisted wire passage technique may be a promising method for safe and reliable TOL treatment using BPA. Résumé: Il est reconnu que l’angioplastie pulmonaire par ballonnet (APB) est une alternative thérapeutique chez les patients atteints d’hypertension pulmonaire thromboembolique chronique inopérable et chez les patients atteints d’hypertension pulmonaire résiduelle après l’endartériectomie pulmonaire. Toutefois, le taux d’innocuité et de réussite du traitement d’une occlusion totale (OT) à l’aide de l’APB est faible, principalement en raison de l’invisibilité des vaisseaux distaux de l’occlusion à l’angiographie. Dans cet article, nous présentons le cas d’une femme de 53 ans atteinte d’hypertension pulmonaire thromboembolique chez qui la recanalisation de l’OT par l’utilisation de l’APB à l’aide d’une échocardiographie intracardiaque a été réussie. La technique de passage du fil assistée par échocardiographie intracardiaque peut constituer une technique prometteuse pour traiter de façon sûre et fiable l’OT à l’aide de l’APB.
