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Транслюминальная баллонная ангиопластика легочных артерий у больных с неоперабельной хронической тромбоэмболической легочной гипертензией (первый опыт в России)
Транслюминальная баллонная ангиопластика легочных артерий у больных с неоперабельной хронической тромбоэмболической легочной гипертензией (первый опыт в России)
Данилов Н.М., Матчин Ю.Г., Мартынюк Т.В. и др. Транслюминальная баллонная ангиопластика легочных артерий у больных с неоперабельной хронической тромбоэмболической легочной гипертензией (первый опыт в России). Consilium Medicum. 2015; 17 (10): 61–66. DOI: 10.26442/2075-1753_2015.10.61-66
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Аннотация
Хроническая тромбоэмболическая легочная гипертензия (ХТЭЛГ) – тяжелое заболевание, в основе которого лежат стойкое нарушение вентиляционно-перфузионного соотношения и повышение легочного сосудистого сопротивления. До последнего времени единственным способом остановить прогрессирование правожелудочковой недостаточности у больных ХТЭЛГ являлась операция тромбэндартерэктомии. Несмотря на высокую эффективность оперативного лечения, в ряде случаев тромбэндартерэктомия противопоказана в связи с дистальным типом поражения легочного сосудистого дерева. Несколько лет назад появился метод эндоваскулярной коррекции тромботического поражения дистальных ветвей легочной артерии – транслюминальная баллонная ангиопластика. Данный метод демонстрирует высокую эффективность и безопасность у неоперабельных больных ХТЭЛГ. Настоящая статья знакомит с первым опытом применения ангиопластики легочных артерий в России.
Ключевые слова: хроническая тромбоэмболическая легочная гипертензия, транслюминальная баллонная ангиопластика легочных артерий.
Ключевые слова: хроническая тромбоэмболическая легочная гипертензия, транслюминальная баллонная ангиопластика легочных артерий.
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Chronic thromboembolic pulmonary hypertension (CTEPH) is a severe disease, based on the persistent violation of ventilation-perfusion ratio and increase in pulmonary vascular resistance. The only way to stop the progression of right ventricular heart failure in patients with CTEPH was thromboendarterectomy, until later. In some cases, thromboendarterectomy was contraindicated in patients with lesions of distal branches of the pulmonary vascular tree, despite the high efficiency of surgical treatment. The method of endovascular correction of thrombosis in distal branches of the pulmonary artery (transluminal balloon angioplasty) was appeared several years ago. This method demonstrated the high efficiency and safety in patients with inoperable CTEPH. This article deals with the first experience of angioplasty of pulmonary arteries application in Russia.
Key words: chronic thromboembolic pulmonary hypertension, transluminal balloon angioplasty of pulmonary arteries.
Key words: chronic thromboembolic pulmonary hypertension, transluminal balloon angioplasty of pulmonary arteries.
Полный текст
Список литературы
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6. Sugimura K, Fukumoto Y, Satoh K et al. Percutaneous transluminal pulmonary angioplasty markedly improves pulmonary hemodynamics and long-term prognosis in patients with chronic thromboembolic pulmonary hypertension. Circ J 2012; 76 (2): 485–8. doi: 10.1253/circj.CJ-11-1217
7. Kataoka M, Inami T, Hayashida K et al. Percutaneous transluminal pulmonary angioplasty for the treatment of chronic thromboembolic pulmonary hypertension. Circ Cardiovasc Interv 2012; 5 (6): 756–62. doi:10.1161/CIRCINTERVENTIONS.112.971390
8. Kim NH, Delcroix M, Jenkins DP et al. Chronic thromboembolic pulmonary hypertension. J Am Coll Cardiol 2013; 62 (25 Suppl): D92–9.
9. Konstantinides SV, Torbicki A, Agnelli G et al. 2014 ESC guide- lines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 2014; 35: 3033–69.
10. Jamieson SW, Kapelanski DP, Sakakibara N et al. Pulmonary endarterectomy: experience and lessons learned in 1,500 cases. Ann Thorac Surg 2003; 76: 1457–62.
11. Ghofrani HA, D’Armini AM, Grimminger F et al. Riociguat for the treatment of chronic thromboembolic pulmonary hypertension. N Engl J Med 2013; 369 (4): 319–29. doi: 10.1056/NEJMoa1209657
12. Ghofrani HA, Schermuly RT, Rose F, Wiedemann R. Sildenafil for long-term treatment of nonoperable chronic thromboembolic pulmonary hypertension. Am J Respir Crit Care Med 2003; 167: 1139–41.
13. Kitani M, Ogawa A, Sarashina T et al. Histological changes of pulmonary arteries treated by balloon pulmonary angioplasty in a patient with chronic thromboembolic pulmonary hypertension. Circ Cardiovasc Interv 2014; 7: 857–9. doi: 10.1161/CIRCINTERVENTIONS.114.001533
14. Andreassen AK, Ragnarsson A, Gude E et al. Balloon pulmonary angioplasty in patients with inoperable chronic thromboembolic pulmonary hypertension. Heart 2013; 99 (19): 1415–20. doi: 10.1136/heartjnl-2012-303549
15. Inami T, Kataoka M, Shimura N et al. Pulmonary edema predictive scoring index (PEPSI), a new index to predict risk of reperfusion pulmonary edema and improvement of hemodynamics in percutaneous transluminal pulmonary angioplasty. JACC Cardiovasc Interv 2013; 6 (7): 725–36. doi: 10.1016/j.jcin.2013.03.009
16. Fukui S, Ogo T, Morita Y et al. Right ventricular reverse remodelling after balloon pulmonary angioplasty. Eur Respir J 2014; 43 (5): 1394–402. doi: 10.1183/09031936.00012914
17. Tsugu T, Murata M, Kawakami T et al. Significance of echocardiographic assessment for right ventricular function after balloon pulmonary angioplasty in patients with chronic thromboembolic induced pulmonary hypertension. Am J Cardiol 2015; 115 (2): 256–61. doi: 10.1016/j.amjcard.2014.10.034
2. Kim NH, Delcroix M, Jenkins DP et al. Chronic thromboembolic pulmonary hypertension. J Am Coll Cardiol 2013; 62 (25 Suppl.): D92–9. doi: 10.1016/j.jacc.2013.10.024
3. Pepke-Zaba J, Delcroix M, Lang I et al. Chronic thromboembolic pulmonary hypertension (CTEPH): results from an interna- tional prospective registry. Circulation 2011; 124 (18): 1973–81. doi:10.1161/ CIRCULATIONAHA.110.015008
4. Feinstein JA, Goldhaber SZ, Lock JE et al. Balloon pulmonary angioplasty for treatment of chronic thromboembolic pulmonary hypertension. Circulation 2001; 103 (1): 10–3. doi: 10.1161/01.CIR.103.1.10
5. Mizoguchi H, Ogawa A, Munemasa M et al. Refined balloon pulmonary angioplasty for inoperable patients with chronic throm- boembolic pulmonary hypertension. Circ Cardiovasc Interv. 2012; 5 (6): 748–55. doi:10.1161/CIRCINTERVENTIONS.112.971077
6. Sugimura K, Fukumoto Y, Satoh K et al. Percutaneous transluminal pulmonary angioplasty markedly improves pulmonary hemodynamics and long-term prognosis in patients with chronic thromboembolic pulmonary hypertension. Circ J 2012; 76 (2): 485–8. doi: 10.1253/circj.CJ-11-1217
7. Kataoka M, Inami T, Hayashida K et al. Percutaneous transluminal pulmonary angioplasty for the treatment of chronic thromboembolic pulmonary hypertension. Circ Cardiovasc Interv 2012; 5 (6): 756–62. doi:10.1161/CIRCINTERVENTIONS.112.971390
8. Kim NH, Delcroix M, Jenkins DP et al. Chronic thromboembolic pulmonary hypertension. J Am Coll Cardiol 2013; 62 (25 Suppl): D92–9.
9. Konstantinides SV, Torbicki A, Agnelli G et al. 2014 ESC guide- lines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 2014; 35: 3033–69.
10. Jamieson SW, Kapelanski DP, Sakakibara N et al. Pulmonary endarterectomy: experience and lessons learned in 1,500 cases. Ann Thorac Surg 2003; 76: 1457–62.
11. Ghofrani HA, D’Armini AM, Grimminger F et al. Riociguat for the treatment of chronic thromboembolic pulmonary hypertension. N Engl J Med 2013; 369 (4): 319–29. doi: 10.1056/NEJMoa1209657
12. Ghofrani HA, Schermuly RT, Rose F, Wiedemann R. Sildenafil for long-term treatment of nonoperable chronic thromboembolic pulmonary hypertension. Am J Respir Crit Care Med 2003; 167: 1139–41.
13. Kitani M, Ogawa A, Sarashina T et al. Histological changes of pulmonary arteries treated by balloon pulmonary angioplasty in a patient with chronic thromboembolic pulmonary hypertension. Circ Cardiovasc Interv 2014; 7: 857–9. doi: 10.1161/CIRCINTERVENTIONS.114.001533
14. Andreassen AK, Ragnarsson A, Gude E et al. Balloon pulmonary angioplasty in patients with inoperable chronic thromboembolic pulmonary hypertension. Heart 2013; 99 (19): 1415–20. doi: 10.1136/heartjnl-2012-303549
15. Inami T, Kataoka M, Shimura N et al. Pulmonary edema predictive scoring index (PEPSI), a new index to predict risk of reperfusion pulmonary edema and improvement of hemodynamics in percutaneous transluminal pulmonary angioplasty. JACC Cardiovasc Interv 2013; 6 (7): 725–36. doi: 10.1016/j.jcin.2013.03.009
16. Fukui S, Ogo T, Morita Y et al. Right ventricular reverse remodelling after balloon pulmonary angioplasty. Eur Respir J 2014; 43 (5): 1394–402. doi: 10.1183/09031936.00012914
17. Tsugu T, Murata M, Kawakami T et al. Significance of echocardiographic assessment for right ventricular function after balloon pulmonary angioplasty in patients with chronic thromboembolic induced pulmonary hypertension. Am J Cardiol 2015; 115 (2): 256–61. doi: 10.1016/j.amjcard.2014.10.034
2. Kim NH, Delcroix M, Jenkins DP et al. Chronic thromboembolic pulmonary hypertension. J Am Coll Cardiol 2013; 62 (25 Suppl.): D92–9. doi: 10.1016/j.jacc.2013.10.024
3. Pepke-Zaba J, Delcroix M, Lang I et al. Chronic thromboembolic pulmonary hypertension (CTEPH): results from an interna- tional prospective registry. Circulation 2011; 124 (18): 1973–81. doi:10.1161/ CIRCULATIONAHA.110.015008
4. Feinstein JA, Goldhaber SZ, Lock JE et al. Balloon pulmonary angioplasty for treatment of chronic thromboembolic pulmonary hypertension. Circulation 2001; 103 (1): 10–3. doi: 10.1161/01.CIR.103.1.10
5. Mizoguchi H, Ogawa A, Munemasa M et al. Refined balloon pulmonary angioplasty for inoperable patients with chronic throm- boembolic pulmonary hypertension. Circ Cardiovasc Interv. 2012; 5 (6): 748–55. doi:10.1161/CIRCINTERVENTIONS.112.971077
6. Sugimura K, Fukumoto Y, Satoh K et al. Percutaneous transluminal pulmonary angioplasty markedly improves pulmonary hemodynamics and long-term prognosis in patients with chronic thromboembolic pulmonary hypertension. Circ J 2012; 76 (2): 485–8. doi: 10.1253/circj.CJ-11-1217
7. Kataoka M, Inami T, Hayashida K et al. Percutaneous transluminal pulmonary angioplasty for the treatment of chronic thromboembolic pulmonary hypertension. Circ Cardiovasc Interv 2012; 5 (6): 756–62. doi:10.1161/CIRCINTERVENTIONS.112.971390
8. Kim NH, Delcroix M, Jenkins DP et al. Chronic thromboembolic pulmonary hypertension. J Am Coll Cardiol 2013; 62 (25 Suppl): D92–9.
9. Konstantinides SV, Torbicki A, Agnelli G et al. 2014 ESC guide- lines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 2014; 35: 3033–69.
10. Jamieson SW, Kapelanski DP, Sakakibara N et al. Pulmonary endarterectomy: experience and lessons learned in 1,500 cases. Ann Thorac Surg 2003; 76: 1457–62.
11. Ghofrani HA, D’Armini AM, Grimminger F et al. Riociguat for the treatment of chronic thromboembolic pulmonary hypertension. N Engl J Med 2013; 369 (4): 319–29. doi: 10.1056/NEJMoa1209657
12. Ghofrani HA, Schermuly RT, Rose F, Wiedemann R. Sildenafil for long-term treatment of nonoperable chronic thromboembolic pulmonary hypertension. Am J Respir Crit Care Med 2003; 167: 1139–41.
13. Kitani M, Ogawa A, Sarashina T et al. Histological changes of pulmonary arteries treated by balloon pulmonary angioplasty in a patient with chronic thromboembolic pulmonary hypertension. Circ Cardiovasc Interv 2014; 7: 857–9. doi: 10.1161/CIRCINTERVENTIONS.114.001533
14. Andreassen AK, Ragnarsson A, Gude E et al. Balloon pulmonary angioplasty in patients with inoperable chronic thromboembolic pulmonary hypertension. Heart 2013; 99 (19): 1415–20. doi: 10.1136/heartjnl-2012-303549
15. Inami T, Kataoka M, Shimura N et al. Pulmonary edema predictive scoring index (PEPSI), a new index to predict risk of reperfusion pulmonary edema and improvement of hemodynamics in percutaneous transluminal pulmonary angioplasty. JACC Cardiovasc Interv 2013; 6 (7): 725–36. doi: 10.1016/j.jcin.2013.03.009
16. Fukui S, Ogo T, Morita Y et al. Right ventricular reverse remodelling after balloon pulmonary angioplasty. Eur Respir J 2014; 43 (5): 1394–402. doi: 10.1183/09031936.00012914
17. Tsugu T, Murata M, Kawakami T et al. Significance of echocardiographic assessment for right ventricular function after balloon pulmonary angioplasty in patients with chronic thromboembolic induced pulmonary hypertension. Am J Cardiol 2015; 115 (2): 256–61. doi: 10.1016/j.amjcard.2014.10.034
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2. Kim NH, Delcroix M, Jenkins DP et al. Chronic thromboembolic pulmonary hypertension. J Am Coll Cardiol 2013; 62 (25 Suppl.): D92–9. doi: 10.1016/j.jacc.2013.10.024
3. Pepke-Zaba J, Delcroix M, Lang I et al. Chronic thromboembolic pulmonary hypertension (CTEPH): results from an interna- tional prospective registry. Circulation 2011; 124 (18): 1973–81. doi:10.1161/ CIRCULATIONAHA.110.015008
4. Feinstein JA, Goldhaber SZ, Lock JE et al. Balloon pulmonary angioplasty for treatment of chronic thromboembolic pulmonary hypertension. Circulation 2001; 103 (1): 10–3. doi: 10.1161/01.CIR.103.1.10
5. Mizoguchi H, Ogawa A, Munemasa M et al. Refined balloon pulmonary angioplasty for inoperable patients with chronic throm- boembolic pulmonary hypertension. Circ Cardiovasc Interv. 2012; 5 (6): 748–55. doi:10.1161/CIRCINTERVENTIONS.112.971077
6. Sugimura K, Fukumoto Y, Satoh K et al. Percutaneous transluminal pulmonary angioplasty markedly improves pulmonary hemodynamics and long-term prognosis in patients with chronic thromboembolic pulmonary hypertension. Circ J 2012; 76 (2): 485–8. doi: 10.1253/circj.CJ-11-1217
7. Kataoka M, Inami T, Hayashida K et al. Percutaneous transluminal pulmonary angioplasty for the treatment of chronic thromboembolic pulmonary hypertension. Circ Cardiovasc Interv 2012; 5 (6): 756–62. doi:10.1161/CIRCINTERVENTIONS.112.971390
8. Kim NH, Delcroix M, Jenkins DP et al. Chronic thromboembolic pulmonary hypertension. J Am Coll Cardiol 2013; 62 (25 Suppl): D92–9.
9. Konstantinides SV, Torbicki A, Agnelli G et al. 2014 ESC guide- lines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 2014; 35: 3033–69.
10. Jamieson SW, Kapelanski DP, Sakakibara N et al. Pulmonary endarterectomy: experience and lessons learned in 1,500 cases. Ann Thorac Surg 2003; 76: 1457–62.
11. Ghofrani HA, D’Armini AM, Grimminger F et al. Riociguat for the treatment of chronic thromboembolic pulmonary hypertension. N Engl J Med 2013; 369 (4): 319–29. doi: 10.1056/NEJMoa1209657
12. Ghofrani HA, Schermuly RT, Rose F, Wiedemann R. Sildenafil for long-term treatment of nonoperable chronic thromboembolic pulmonary hypertension. Am J Respir Crit Care Med 2003; 167: 1139–41.
13. Kitani M, Ogawa A, Sarashina T et al. Histological changes of pulmonary arteries treated by balloon pulmonary angioplasty in a patient with chronic thromboembolic pulmonary hypertension. Circ Cardiovasc Interv 2014; 7: 857–9. doi: 10.1161/CIRCINTERVENTIONS.114.001533
14. Andreassen AK, Ragnarsson A, Gude E et al. Balloon pulmonary angioplasty in patients with inoperable chronic thromboembolic pulmonary hypertension. Heart 2013; 99 (19): 1415–20. doi: 10.1136/heartjnl-2012-303549
15. Inami T, Kataoka M, Shimura N et al. Pulmonary edema predictive scoring index (PEPSI), a new index to predict risk of reperfusion pulmonary edema and improvement of hemodynamics in percutaneous transluminal pulmonary angioplasty. JACC Cardiovasc Interv 2013; 6 (7): 725–36. doi: 10.1016/j.jcin.2013.03.009
16. Fukui S, Ogo T, Morita Y et al. Right ventricular reverse remodelling after balloon pulmonary angioplasty. Eur Respir J 2014; 43 (5): 1394–402. doi: 10.1183/09031936.00012914
17. Tsugu T, Murata M, Kawakami T et al. Significance of echocardiographic assessment for right ventricular function after balloon pulmonary angioplasty in patients with chronic thromboembolic induced pulmonary hypertension. Am J Cardiol 2015; 115 (2): 256–61. doi: 10.1016/j.amjcard.2014.10.034
Авторы
Н.М.Данилов*, Ю.Г.Матчин, Т.В.Мартынюк, И.С.Федотенков, И.Е.Чазова
ФГБУ Российский кардиологический научно-производственный комплекс Минздрава России. 121552, Россия, Москва, ул. 3-я Черепковская, д. 15а
*ndanilov1@gmail.com
ФГБУ Российский кардиологический научно-производственный комплекс Минздрава России. 121552, Россия, Москва, ул. 3-я Черепковская, д. 15а
*ndanilov1@gmail.com
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N.M.Danilov*, Yu.G.Matchin, T.V.Martynyuk, I.S.Fedotenkov, I.E.Chazova
Russian Cardiological Scientific-Industrial Complex of the Ministry of Health of the Russian Federation. 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a
*ndanilov1@gmail.com
Russian Cardiological Scientific-Industrial Complex of the Ministry of Health of the Russian Federation. 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a
*ndanilov1@gmail.com
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