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Balloon pulmonary angioplasty (BPA) is an emerging minimally invasive procedure to treat chronic thromboembolic pulmonary hypertension (CTEPH) in people who are not suitable for pulmonary thromboendarterectomy (PTE) or still have residual pulmonary hypertension and areas of narrowing in the pulmonary arterial tree following previous PTE. [1] [2]
The standard pulmonary artery catheter has two lumens (Swan-Ganz) and is equipped with an inflatable balloon at the tip, which facilitates its placement into the pulmonary artery through the flow of blood. The balloon, when inflated, causes the catheter to "wedge" in a small pulmonary blood vessel.
Angioplasty is used to treat venous stenosis affecting dialysis access, with drug-coated balloon angioplasty proving to have better 6 month and 12 month patency than conventional balloon angioplasty. [13] Angioplasty is occasionally used to treat residual subclavian vein stenosis following decompression surgery for thoracic outlet syndrome. [14]
The balloon inflates and deflates via counter pulsation, meaning it actively deflates in systole and inflates in diastole. Systolic deflation decreases afterload through a vacuum effect and indirectly increases forward flow from the heart. Diastolic inflation increases blood flow to the coronary arteries via retrograde flow. These actions ...
Balloon pulmonary angioplasty (BPA) and pulmonary vasodilator drug treatment may be considered for those people that are not suitable for surgery. [ 11 ] Specialist imaging using either magnetic resonance or invasive PA is necessary to determine risks and benefits of interventional treatment with PEA or BPA.
A balloon catheter is a type of "soft" catheter with an inflatable "balloon" at its tip which is used during a catheterization procedure to enlarge a narrow opening or passage within the body. The deflated balloon catheter is positioned, then inflated to perform the necessary procedure, and deflated again in order to be removed.
Since the pulmonary resistance is proportional to the pressure driving the pulmonary flow (=), it follows that the pulmonary pressure decreases. This in turn means that the work per time (power) decreases because it is equal to the pressure gradient times the volumetric flow , which in this case is the cardiac output.
Blood flow is usually interrupted in the procedure, increasing the risk of the patient losing a limb. [9] At home, the ideas that went through Fogarty's head concerned different ways of making the procedure better, and he especially concentrated on avoiding the risky incisions. He tinkered with a urethral catheter and a balloon in his attic ...