循環器ジャーナル70巻3号

2022年07月発行

特集 進化するカテーテルインターベンション—適応の広がりとデバイスの革新 Ⅲ章　構造的心疾患（SHD）に対するインターベンション

慢性肺動脈血栓塞栓症に対するバルーン肺動脈形成術（BPA）

著者： 杉村宏一郎¹

所属機関： ¹国際医療福祉大学成田病院循環器内科

ページ範囲：P.440 - P.445

Point
・CTEPHの第一選択の治療は外科的治療である．
・日本のBPAの長期成績として5年生存率90%以上と報告されている．
・BPAの適応は広がりつつある．
・欧米のBPAの成績が報告され，世界的な議論が必要となっている．

参考文献

1）Delcroix M, Torbicki A, Gopalan D, et al : ERS statement on chronic thromboembolic pulmonary hypertension. Eur Respir J 57 : 2002828, 2021

2）Ogo T, Shimokawahara H, Kinoshita H, et al : Selexipag for the treatment of chronic thromboembolic pulmonary hypertension. Eur Respir J : 2101694, 2021

3）Coquoz N, Weilenmann D, Stolz D, et al : Multicentre observational screening survey for the detection of CTEPH following pulmonary embolism. Eur Respir J 51 : 1702505, 2018

4）Ende-Verhaar YM, Cannegieter SC, Vonk Noordegraaf A, et al : Incidence of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism : a contemporary view of the published literature. Eur Respir J 49 : 1601792, 2017

5）Rang IM, Pesavento R, Bonderman D, et al : Risk factors and basic mechanisms of chronic thromboembolic pulmonary hypertension : a current understanding. Eur Respir J 41 : 462-468, 2013

6）Zabini D, Heinemann A, Foris V, et al : Comprehensive analysis of inflammatory markers in chronic thromboembolic pulmonary hypertension patients. Eur Respir J 44 : 951-962, 2014

7）Yaoita N, Satoh K, Satoh T, et al : Thrombin-Activatable Fibrinolysis Inhibitor in Chronic Thromboembolic Pulmonary Hypertension. Arterioscler Thromb Vasc Biol 36 : 1293-1301, 2016

8）Madani M, Mayer E, Fadel E, et al : Pulmonary Endarterectomy. Patient Selection, Technical Challenges, and Outcomes. Ann Am Thorac Soc 13（Suppl 3） : S240-S247, 2016

9）Pepke-Zaba J, Delcroix M, Lang I, et al : Chronic thromboembolic pulmonary hypertension（CTEPH） : results from an international prospective registry. Circulation 124 : 1973-1981, 2011

10）Sugimura K, Fukumoto Y, Shimokawa H, et al : Percutaneous transluminal pulmonary angioplasty markedly improves pulmonary hemodynamics and long-term prognosis in patients with chronic thromboembolic pulmonary hypertension. Circ J 76 : 485-488, 2012

11）Mizoguchi H, Ogawa A, Munemasa M, et al : Refined balloon pulmonary angioplasty for inoperable patients with chronic thromboembolic pulmonary hypertension. Circ Cardiovasc Interv 5 : 748-755, 2012

12）Ogo T, Fukuda T, Tsuji A, et al : Efficacy and safety of balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension guided by cone-beam computed tomography and electrocardiogram-gated area detector computed tomography. Eur J Radiol 89 : 270-276, 2017

13）Koike H, Sueyoshi E, Sakamoto I, et al : Quantification of lung perfusion blood volume（lung PBV）by dual-energy CT in patients with chronic thromboembolic pulmonary hypertension（CTEPH）before and after balloon pulmonary angioplasty（BPA） : Preliminary results. Eur J Radiol 85 : 1607-1612, 2016

14）Kamada H, Ota H, Nakamura M, et al : Quantification of vortex flow in pulmonary arteries of patients with chronic thromboembolic pulmonary hypertension. Eur J Radiol 148 : 110142, 2022

15）Inami T, Kataoka M, Shimura N, et al : Pressure-wire-guided percutaneous transluminal pulmonary angioplasty : a breakthrough in catheter-interventional therapy for chronic thromboembolic pulmonary hypertension. JACC Cardiovasc Interv 7 : 1297-1306, 2014

16）Shimokawahara H, Nagayoshi S, Ogawa A, et al : Continual Improvement in Pressure Gradient at the Lesion After Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension. Can J Cardiol 37 : 1232-1239, 2021

17）Feinstein JA, Goldhaber SZ, Lock JE, et al : Balloon pulmonary angioplasty for treatment of chronic thromboembolic pulmonary hypertension. Circulation 103 : 10-13, 2001

18）Aoki T, Sugimura K, Shimokawa H, et al : Comprehensive evaluation of the effectiveness and safety of balloon pulmonary angioplasty for inoperable chronic thrombo-embolic pulmonary hypertension : long-term effects and procedure-related complications. Eur Heart J 38 : 3152-3159, 2017

19）Ogawa A, Satoh T, Fukuda T, et al : Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension : Results of a Multicenter Registry. Circ Cardiovasc Qual Outcomes 10 : e004029, 2017

20）Ito R, Yamashita J, Sasaki Y, et al : Efficacy and safety of balloon pulmonary angioplasty for residual pulmonary hypertension after pulmonary endarterectomy. Int J Cardiol 334 : 105-109, 2021

21）Wiedenroth CB, Liebetrau C, Breithecker A, et al : Combined pulmonary endarterectomy and balloon pulmonary angioplasty in patients with chronic thromboembolic pulmonary hypertension. J Heart Lung Transplant 35 : 591-596, 2016

22）Aoki T, Sugimura K, Terui Y, et al : Beneficial effects of riociguat on hemodynamic responses to exercise in CTEPH patients after balloon pulmonary angioplasty-A randomized controlled study. Int J Cardiol Heart Vasc 29 : 100579, 2020

23）Kawakami T, Ogawa A, Miyaji K, et al : Novel Angiographic Classification of Each Vascular Lesion in Chronic Thromboembolic Pulmonary Hypertension Based on Selective Angiogram and Results of Balloon Pulmonary Angioplasty. Circ Cardiovasc Interv 9 : e003318, 2016

24）Lang IM, Matsubara H : Balloon pulmonary angioplasty for the treatment of chronic thromboembolic pulmonary hypertension : is Europe behind? Eur Respir J 53 : 1900843, 2019

25）Wiedenroth CB, Olsson KM, Guth S, et al : Balloon pulmonary angioplasty for inoperable patients with chronic thromboembolic disease. Pulm Circ 8 : 2045893217753122, 2018

26）Mizoguchi H, Ogawa A, Munemasa M, et al : Refined balloon pulmonary angioplasty for inoperable patients with chronic thromboembolic pulmonary hypertension. Circ Cardiovasc Interv 5 : 748-755, 2012

27）Kataoka M, Inami T, Hayashida K, et al : Percutaneous transluminal pulmonary angioplasty for the treatment of chronic thromboembolic pulmonary hypertension. Circ Cardiovasc Interv 5 : 756-762, 2012

28）Inami T, Kataoka M, Yanagisawa R, et al : Long-Term Outcomes After Percutaneous Transluminal Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension. Circulation 134 : 2030-2032, 2016

29）Andreassen AK, Ragnarsson A, Gude E, et al : Balloon pulmonary angioplasty in patients with inoperable chronic thromboembolic pulmonary hypertension. Heart 99 : 1415-1420, 2013

30）Roik M, Wretowski D, Łabyk A, et al : Refined balloon pulmonary angioplasty-A therapeutic option in very elderly patients with chronic thromboembolic pulmonary hypertension. J Interv Cardiol 30 : 249-255, 2017

31）Kurzyna M, Darocha S, Pietura R, et al : Changing the strategy of balloon pulmonary angioplasty resulted in a reduced complication rate in patients with chronic thromboembolic pulmonary hypertension. A single-centre European experience. Kardiol Pol 75 : 645-654, 2017

32）Olsson KM, Wiedenroth CB, Kamp JC, et al : Balloon pulmonary angioplasty for inoperable patients with chronic thromboembolic pulmonary hypertension : the initial German experience. Eur Respir J 49 : 1602409, 2017

33）Kwon W, Yang JH, Park TK, et al : Impact of Balloon Pulmonary Angioplasty on Hemodynamics and Clinical Outcomes in Patients with Chronic Thromboembolic Pulmonary Hypertension : the Initial Korean Experience. J Korean Med Sci 33 : e24, 2018

34）Velázquez M, Albarrán A, Hernández I, et al : Balloon Pulmonary Angioplasty for Inoperable Patients With Chronic Thromboembolic Pulmonary Hypertension. Observational Study in a Referral Unit. Rev Esp Cardiol（Engl Ed）72 : 224-232, 2019

35）Brenot P, Jaïs X, Taniguchi Y, et al : French experience of balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension. Eur Respir J 53 : 1802095, 2019

36）Anand V, Frantz RP, DuBrock H, et al : Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension : Initial Single-Center Experience. Mayo Clin Proc Innov Qual Outcomes 3 : 311-318, 2019

37）Chen ZW, Wu CK, Kuo PH, et al : Efficacy and safety of balloon pulmonary angioplasty in patients with inoperable chronic thromboembolic pulmonary hypertension. J Formos Med Assoc 120 : 947-955, 2021