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Novel scoring index may guide percutaneous transluminal pulmonary angioplasty
A combined approach using pressure-wire guidance and a novel predictive scoring index was associated with reduced reperfusion pulmonary edema and vessel complications in patients undergoing percutaneous transluminal pulmonary angioplasty.
Researchers aimed to evaluate safety and efficacy outcomes of pressure-wire-guided percutaneous transluminal pulmonary angioplasty. The cohort included 103 patients with chronic thromboembolic pulmonary hypertension. The researchers evaluated 350 consecutive sessions conducted from 2009 to 2013. The Pulmonary Edema Predictive Scoring Index (PEPSI) was developed to assess reperfusion pulmonary edema risk.
During the study period, 140 percutaneous transluminal pulmonary angioplasty procedures were performed without use of a pressure-wire guide, 65 with the scoring index alone, and 145 with the scoring index and pressure-wire guidance.
Percutaneous transluminal pulmonary angioplasty sessions were completed after reaching a score of <35.4 with guidance from the index score and with every target lesion reaching a mean distal pulmonary arterial pressure of <35 mm Hg with guidance from the pressure wire.
The group that used both pressure wire and PEPSI had the lowest occurrence of clinically critical reperfusion pulmonary edema and vessel injuries (0% and 6.9%, respectively). The combined approach also was associated with the same hemodynamic improvements and fewer numbers of target lesions treated and sessions performed, according to the results.
“There were no clinically critical reperfusion pulmonary edema and vessel injuries when percutaneous transluminal pulmonary angioplasty was performed using the pressure-wire and PEPSI-guided technique. Pressure wire was efficient in obtaining good clinical results. Therefore, the findings in this study indicated that pressure-wire and PEPSI-guided percutaneous transluminal pulmonary angioplasty is effective in chronic thromboembolic pulmonary hypertension, improves procedural success rates and reduces the risk of the procedure,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.