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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]
There are also balloon catheters used in angioplasty procedures such as plain balloon catheters that is useful in passing tight vessel stenosis, drug coated balloons that contains paclitaxel on the surface to prevent smooth muscle cells proliferation of the vessel walls, thus reducing the likehood of vessel blockage in the future, high pressure ...
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]
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. [8]
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.
The balloon, when inflated, causes the catheter to "wedge" in a small pulmonary blood vessel. So wedged, the catheter can provide an indirect measurement of the pressure in the left atrium of the heart, showing a mean pressure, in addition to a, x, v, and y waves which have implications for status of the left atria and the mitral valve.
When the catheter is in position, a thin wire with a balloon is guided to the place of blockage. The balloon is inflated to widen the artery, allowing the blood to flow freely. Often, a stent is used, and as the balloon is inflated, the stent in place expands and holds open the artery.
Diagram of a pulmonary artery catheter in position. The pulmonary wedge pressure (PWP) (also called pulmonary arterial wedge pressure (PAWP), pulmonary capillary wedge pressure (PCWP), pulmonary artery occlusion pressure (PAOP), or cross-sectional pressure) is the pressure measured by wedging a pulmonary artery catheter with an inflated balloon into a small pulmonary arterial branch. [1]