Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-28T01:59:01.931Z Has data issue: false hasContentIssue false
  • English
  • Français

Follow-up results of Cutting Balloon angioplasty used to relieve stenoses in small pulmonary arteries

Published online by Cambridge University Press:  18 November 2005

Lisa Bergersen ,
Kathy J. Jenkins ,
Kimberlee Gauvreau  and
James E. Lock
Lisa Bergersen
Affiliation:
Department of Cardiology, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts, United States of America
Kathy J. Jenkins
Affiliation:
Department of Cardiology, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts, United States of America
Kimberlee Gauvreau
Affiliation:
Department of Cardiology, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts, United States of America
James E. Lock
Affiliation:
Department of Cardiology, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts, United States of America
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: We sought to determine if the acute gains in pulmonary arterial diameter achieved by using Cutting Balloons to dilate stenoses in small arteries are maintained at follow-up. Methods: A search of our database identified all patients who underwent dilation with Cutting Balloons for pulmonary arterial stenosis between June 2001 and September 2003. We reviewed the procedural and angiographic data obtained at the initial and follow-up procedures. Results: Over the period of study, 29 patients with a median age of 3.7 years, and a range from 0.4 to 46.6, underwent treatment with Cutting Balloons at 41 procedures for one or more pulmonary arterial obstructions resistant to conventional angioplasty. At the initial procedure, we enlarged 79 vessels, with an initial minimal luminal diameter of 1.5 plus or minus 0.8 millimetres, to a diameter of 3.0 plus or minus 1.1 millimetres (p smaller than 0.001). Angiographic data indicated that 49% of the vessels showed evidence of vascular damage not requiring intervention, while stents were placed in 9 vessels. Follow-up angiography was available for 39 of the vessels, evaluated at a median of 6 months, with a range from 3 to 24 months, after the initial procedure. In these vessels, there was a mean loss of 10 plus or minus 25% in luminal diameter, p not significant. Of the 39 vessels, 8 had returned to a diameter within half of the initial diameter, giving a failure rate at follow-up of 21%, with 95% confidence intervals from 9% to 36%. All complications were identified within 24 hours of the catheterization procedure, and there were no late complications or deaths during the period of follow-up. Placement of stents produced both greater increases in diameter at the initial procedure (p smaller than 0.001), and greater losses at follow-up (p equal to 0.01). Conclusions: Despite the frequent identification of intravascular trauma, initial gains in luminal diameter after use of Cutting Balloons to dilate stenotic pulmonary arteries are maintained at follow-up.

Keywords

Interventional catheterizationpulmonary circulationcatheterization
Type
Original Article
Information
Cardiology in the Young , Volume 15 , Issue 6 , December 2005 , pp. 605 - 610
Copyright
© 2005 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Rocchini A, Kveselis D, MacDonald D, Crowley D, Snider R, Rosenthal A. Use of balloon angioplasty to treat peripheral pulmonary stenosis. Am J Cardiol 1984; 54: 1069–1073.Google Scholar
Rothman A, Perry S, Keane J, Lock J. Early results and follow-up of balloon angioplasty for branch pulmonary artery stenoses. J Am Coll Cardiol 1990; 15: 1109–1117.Google Scholar
Hosking M, Thomaidis C, Hamilton R, Burrows P, Freedom R, Benson L. Clinical impact of balloon angioplasty for branch pulmonary arterial stenosis. Am J Cardiol 1992; 69: 1467–1470.Google Scholar
Zeevi B, Berant M, Blieden L. Midterm clinical impact versus procedural success of balloon angioplasty for pulmonary artery stenosis. Pediatr Cardiol 1997; 18: 101–106.Google Scholar
Gentles T, Lock J, Perry S. High pressure balloon angioplasty for branch pulmonary artery stenosis: early experience. J Am Coll Cardiol 1993; 22: 867–872.Google Scholar
Kan J, Marvin W, Bass J, Muster A, Murphy J. Balloon angioplasty-branch pulmonary artery stenosis: results of the valvuloplasty and angioplasty of congenital anomalies registry. Am J Cardiol 1990; 65: 798–801.Google Scholar
Bush D, Hoffman T, Del Rosario J, Eiriksson H, Rome J. Frequency of restenosis after balloon pulmonary arterioplasty and its causes. Am J Cardiol 2000; 86: 1205–1209.Google Scholar
Magee A, Wax D, Saiki Y, Rebekya I, Benson L. Experimental branch pulmonary artery stenosis angioplasty using a novel cutting balloon. Can J Cardiol 1998; 4: 1037–1041.Google Scholar
Schneider M, Zartner O, Magee A. Images in cardiology: cutting balloon for treatment of severe peripheral pulmonary stenosis in a child. Heart 1999; 82: 108.Google Scholar
Rhodes J, Lane G, Mesia I, et al. Cutting balloon angioplasty for children with small-vessel pulmonary artery stenoses. Cathet Cardiovasc Intervent 2002; 55: 73–77.Google Scholar
Bergersen L, Perry S, Lock J. Effect of cutting balloon angioplasty on resistant pulmonary artery stenosis. Am J Cardiol 2003; 91: 185–189.Google Scholar
Sugiyama H, Vedtman G, Norgard G, Lee K, Chaturvedi R, Benson L. Bladed balloon angioplasty for peripheral pulmonary artery stenosis. Cathet Cardiovasc Interv 2004; 62: 71–77.Google Scholar