Impact and safety of balloon pulmonary angioplasty for elderly patients

Taito Nagai; Nobutaka Ikeda; Raisuke Iijima; Hidehiko Hara; Masato Nakamura

doi:10.1002/pul2.12009

Impact and safety of balloon pulmonary angioplasty for elderly patients

Pulm Circ. 2022 Jan 3;12(1):e12009. doi: 10.1002/pul2.12009. eCollection 2022 Jan.

Authors

Taito Nagai¹, Nobutaka Ikeda¹, Raisuke Iijima¹, Hidehiko Hara¹, Masato Nakamura¹

Affiliation

¹ Division of Cardiovascular Medicine Toho University Ohashi Medical Center Tokyo Japan.

Abstract

Recently, balloon pulmonary angioplasty (BPA) for chronic thromboembolic pulmonary hypertension (CTEPH) and chronic thromboembolic pulmonary disease (CTEPD) has become an established procedure with stable results. The number of elderly CTEPH/CTEPD patients has also increased due to the widespread recognition of the disease concept. However, the reports of BPA in the elderly are limited. The aim of this study was to evaluate the efficacy and safety of BPA in elderly patients (>80 years). From April 2016 to December 2020, 344 BPA sessions (74 patients) were performed. The safety and efficacy of the BPA procedures were compared in the younger group (<80 years; 278 sessions) and the elderly group (≥80 years; 66 sessions). The hemodynamic parameters were significantly improved in both groups (mean pulmonary arterial pressure: 34.4 ± 9.9 → 21.2 ± 6.2 mmHg, p < 0.001 and 33.2 ± 9.6 → 21.8 ± 8.5 mmHg, p < 0.001; pulmonary vascular resistance: 474.5 ± 248.6 → 201.3 ± 108.7 dyne sec cm^-5, p < 0.001 and 496.4 ± 290.9 → 260.5 ± 120.2 dyne sec cm^-5, p = 0.002, in younger and elderly group, respectively). The rate of death within 30 days of BPA (0.3% vs. 0%, p = 1.000) and use of positive pressure ventilation (1.4% vs. 3.0%, p = 0.600) were not different between the groups (younger vs. elderly, respectively). BPA significantly improved the hemodynamic parameters of elderly CTEPH/CTEPD patients, and the safety is comparable to that of younger patients.

Keywords: BPA; CTEPD; CTEPH; elderly.