Balloon pulmonary angioplasty for occlusive lesions of pulmonary artery in Takayasu arteritis: A cohort study
- 1Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Abstract
Background: Occlusive pulmonary arterial lesions represent a major technical challenge for balloon pulmonary angioplasty (BPA) in patients with Takayasu arteritis–associated pulmonary artery involvement. However, evidence and procedural guidance regarding BPA for occlusive lesions in this population remain limited.
Objectives: This study aimed to summarize our center experience with BPA for occlusive pulmonary arterial lesions in patients with Takayasu arteritis and to identify potential risk factors associated with restenosis after BPA.
Design: Retrospective cohort.
Methods: We retrospectively enrolled patients with Takayasu arteritis who had occlusive pulmonary arterial lesions. Lesions were morphologically categorized as subtotal or total occlusions. Total occlusions were further subclassified as cone-shaped, pouch-like, or ostial occlusions.
Results: We included 66 patients with Takayasu arteritis, in whom 182 occlusive lesions were identified. In terms of locations, most ostial occlusions (56.52%) located lobar, while other kinds of lesions more common located segmentally. Total occlusions more frequently required guide-extension catheter support than subtotal occlusions (70.21% vs. 40.63%, P<0.001). Hard-tip guidewires were required for revascularization in 53.85% of ostial occlusions, compared with only 3.13% of subtotal occlusions. Lesion-level technical success rates among attempted lesions decreased with increasing lesion complexity: 100% for subtotal occlusions, 96.0% for cone-shaped occlusions, 68.4% for pouch-like occlusions, and 43.8% for ostial occlusions. The corresponding recanalization rates among all identified lesions were 78.69%, 88.9%, 52.04%, and 10.14%, respectively. In exploratory univariable Firth penalized logistic regression, irregular anticoagulation was associated with a higher likelihood of restenosis (OR 8.51, 95% CI 1.39–60.91; P=0.021), whereas baseline hemodynamics were not associated with restenosis.
Conclusion: The techniques and devices illustrated in this study might guide the BPA performance in addressing occlusive lesions.
Related
- Bilateral Pulmonary Arterial Involvement in Takayasu Arteritis
- Reduction in Right Ventricular Stroke Work Index After Balloon Pulmonary Angioplasty is Associated With Long-Term Prognosis in Chronic Thromboembolic Pulmonary Hypertension.
- Pulmonary Endarterectomy After Balloon Pulmonary Angioplasty: A Single‐Center USA Experience
- Pulmonary Veno-Occlusive Disease in Systemic Sclerosis: A Scoping Review of the Literature.
- Recanalization of a diagonal coronary branch in Takayasu arteritis
BibTeX
@article{li2026balloon,
title = {{Balloon pulmonary angioplasty for occlusive lesions of pulmonary artery in Takayasu arteritis: A cohort study}},
author = {Xin Li and Tao Yang and Qin Luo and Qing Zhao and Zhihua Huang and Anqi Duan and Yijia Wang and Luyang Gao and Sicong Li and Qi Wang and Jingjing Xiang and Huiyi Liu and Changming Xiong and Zhihui Zhao and Zhihong Liu},
journal = {Therapeutic Advances in Respiratory Disease},
year = {2026},
month = sep,
doi = {10.1177/17534666261492547},
url = {https://doi.org/10.1177/17534666261492547},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Balloon pulmonary angioplasty for occlusive lesions of pulmonary artery in Takayasu arteritis: A cohort study
AU - Xin Li
AU - Tao Yang
AU - Qin Luo
AU - Qing Zhao
AU - Zhihua Huang
AU - Anqi Duan
AU - Yijia Wang
AU - Luyang Gao
AU - Sicong Li
AU - Qi Wang
AU - Jingjing Xiang
AU - Huiyi Liu
AU - Changming Xiong
AU - Zhihui Zhao
AU - Zhihong Liu
PY - 2026
DA - 2026/09/28
JO - Therapeutic Advances in Respiratory Disease
DO - 10.1177/17534666261492547
UR - https://doi.org/10.1177/17534666261492547
AB - Background: Occlusive pulmonary arterial lesions represent a major technical challenge for balloon pulmonary angioplasty (BPA) in patients with Takayasu arteritis–associated pulmonary artery involvement. However, evidence and procedural guidance regarding BPA for occlusive lesions in this population remain limited. Objectives: This study aimed to summarize our center experience with BPA for occlusive pulmonary arterial lesions in patients with Takayasu arteritis and to identify potential risk factors associated with restenosis after BPA. Design: Retrospective cohort. Methods: We retrospectively enrolled patients with Takayasu arteritis who had occlusive pulmonary arterial lesions. Lesions were morphologically categorized as subtotal or total occlusions. Total occlusions were further subclassified as cone-shaped, pouch-like, or ostial occlusions. Results: We included 66 patients with Takayasu arteritis, in whom 182 occlusive lesions were identified. In terms of locations, most ostial occlusions (56.52%) located lobar, while other kinds of lesions more common located segmentally. Total occlusions more frequently required guide-extension catheter support than subtotal occlusions (70.21% vs. 40.63%, P<0.001). Hard-tip guidewires were required for revascularization in 53.85% of ostial occlusions, compared with only 3.13% of subtotal occlusions. Lesion-level technical success rates among attempted lesions decreased with increasing lesion complexity: 100% for subtotal occlusions, 96.0% for cone-shaped occlusions, 68.4% for pouch-like occlusions, and 43.8% for ostial occlusions. The corresponding recanalization rates among all identified lesions were 78.69%, 88.9%, 52.04%, and 10.14%, respectively. In exploratory univariable Firth penalized logistic regression, irregular anticoagulation was associated with a higher likelihood of restenosis (OR 8.51, 95% CI 1.39–60.91; P=0.021), whereas baseline hemodynamics were not associated with restenosis. Conclusion: The techniques and devices illustrated in this study might guide the BPA performance in addressing occlusive lesions.
SN - 1753-4658
SN - 1753-4666
ER -