Affiliation:
1. Phase I Clinical Trial Research Center Beijing Shijitan Hospital Affiliated to Capital Medical University Beijing China
2. Department of Cardiology The First Affiliated Hospital of Zhengzhou University Zhengzhou China
3. Department of Cardiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
4. Medical Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
Abstract
AbstractBackgroundThe efficacy and safety of percutaneous transluminal pulmonary angioplasty (PTPA) for Takayasu arteritis‐associated pulmonary hypertension (TA‐PH) remain unclear.ObjectivesTo examine the efficacy and safety of PTPA in TA‐PH.MethodsPubMed, Embase, and the Cochrane Central Register of Controlled Trials Library were searched from inception to August 18, 2022, for articles investigating the efficacy and safety of PTPA for TA‐PH. The primary efficacy outcomes were pulmonary vascular resistance (PVR) changes from baseline to re‐evaluation and 6‐minute walking distance (6MWD). The safety outcome was procedure‐related complications.ResultsFive articles comprising 104 patients with TA‐PH who underwent PTPA were included. The scores of article quality, as assessed using the methodological index for nonrandomized studies tool, were high, ranging from 13 to 15 points. The pooled treatment effects of PVR (weighted mean difference [WMD]: −4.8 WU; 95% confidence interval [CI]: −6.0 to −3.5 WU; I2 = 0.0%), 6MWD (WMD: 101.9 m; 95% CI: 60.3–143.6 m; I2 = 70.4%) significantly improved. Procedure‐related complications, which predominantly present as pulmonary artery injury and pulmonary injury, occurred in 32.0% of the included patients. Periprocedural death occurred in one patient (1.0%, 1/100).ConclusionsPatients with TA‐PH could benefit from PTPA in terms of hemodynamics and exercise tolerance, at the expense of procedure‐related complications. PTPA should be encouraged to enhance the treatment response in TA‐PH. These findings need to be confirmed by further studies, ideally, randomized controlled trials.RegistrationPROSPERO CRD42022354087.
Subject
Cardiology and Cardiovascular Medicine,Radiology, Nuclear Medicine and imaging,General Medicine
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