Percutaneous transluminal pulmonary angioplasty for Takayasu arteritis-associated pulmonary hypertension: A single-arm meta-analysis

The efficacy and safety of percutaneous transluminal pulmonary angioplasty (PTPA) for Takayasu arteritis-associated pulmonary hypertension (TA-PH) remain unclear. To examine the efficacy and safety of PTPA in TA-PH. PubMed, Embase, and the Cochrane Central Register of Controlled Trials Library were...

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Published in:Catheterization and cardiovascular interventions 2023-09, Vol.102 (3), p.558-567
Main Authors: Sun, Ming-Li, Zhu, Yong-Jian, Zhou, Yu-Ping, Zhu, Xi-Jie, Yang, Yin-Jian, Cheng, Chun-Yan, Mei, Ke-Yi, Li, Xian-Mei, Liu, Chao, Xu, Xi-Qi, Sun, Kai, Jing, Zhi-Cheng
Format: Article
Language:English
Subjects:
Angioplasty
Arteritis
Clinical trials
Hemodynamics
Hypertension
Lungs
Meta-analysis
Pulmonary arteries
Pulmonary artery
Pulmonary hypertension
Safety
Takayasu's disease
Vein & artery diseases
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Summary:The efficacy and safety of percutaneous transluminal pulmonary angioplasty (PTPA) for Takayasu arteritis-associated pulmonary hypertension (TA-PH) remain unclear. To examine the efficacy and safety of PTPA in TA-PH. PubMed, 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. Five 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; I  = 0.0%), 6MWD (WMD: 101.9 m; 95% CI: 60.3-143.6 m; I  = 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). Patients 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. PROSPERO CRD42022354087.
ISSN:1522-1946
1522-726X
DOI:10.1002/ccd.30773