Balloon pulmonary angioplasty is a leading-edge treatment for chronic thromboembolic pulmonary hypertension (CTEPH). Penn Medicine physicians are among just a small group of specialists with the expertise to perform this complex procedure.
What Is a Balloon Pulmonary Angioplasty?
A balloon pulmonary angioplasty is a minimally invasive peripheral intervention procedure to remove multiple blood clots from the pulmonary arteries, which supply blood to the lungs.
A blood clot in the lungs is called a pulmonary embolism (pulmonary embolus). People with chronic thromboembolic pulmonary hypertension (CTEPH) have many pulmonary emboli in their lungs. Over time, these blood clots can cause scar tissue to develop in the pulmonary arteries, increasing arterial blood pressure and restricting blood flow to the lungs. When the lungs don't receive the blood and oxygen they need, people experience chest pain, shortness of breath or dizziness.
With a balloon pulmonary angioplasty, an interventional cardiologist uses flexible, hollow tubes (catheters) and small balloons to push clots and scar tissue out of the way, restoring blood flow.
This procedure reduces symptoms such as shortness of breath and allows people to exercise more easily.
Preparing for a Balloon Pulmonary Angioplasty
Your care team will give you specific instructions to prepare for a balloon pulmonary angioplasty. It's important to share a full medication list with your provider, including any supplements or over-the-counter medications. Your provider may instruct you to stop taking specific medicines for a brief period before the procedure. You may need to stop eating or drinking for several hours before the treatment.
What to Expect During a Balloon Pulmonary Angioplasty
A balloon pulmonary angioplasty usually lasts between two and four hours. You receive anesthesia so you stay calm and comfortable during the procedure. An interventional cardiologist, interventional echocardiographer and anesthesia specialist work together to perform the procedure.
During a balloon pulmonary angioplasty, an interventional cardiologist:
- Makes a small incision in your groin or neck and inserts a catheter through a blood vessel
- Guides the catheter to your pulmonary arteries with the help of imaging guidance
- Inflates a balloon in the blocked pulmonary artery to push clots out of the way, break up any scar tissue and restore blood flow
Many people need more than one balloon pulmonary angioplasty to effectively treat CTEPH. You will most likely have four to six treatments over several months. Many people have their first two treatments within two weeks, then have additional procedures one to three months later. The total number of treatments you need varies depending on the number and location of blood clots in your lungs.
Balloon Pulmonary Angioplasty Recovery
You usually stay in the hospital overnight after the procedure. Your provider gives you specific instructions during recovery, including a timeline for when you can return to your usual activities. You'll likely need to take blood thinners long-term to prevent blood clots from re-forming.
After balloon pulmonary angioplasty, your provider may recommend pulmonary rehabilitation. A pulmonary rehabilitation program includes education and exercise guidance to help improve your breathing and lung function long-term.
Benefits and Risks of Balloon Pulmonary Angioplasty
Balloon pulmonary angioplasty can significantly improve your blood flow, heart function and ability to exercise. Many people who have this procedure get back to their usual activities without shortness of breath or dizziness.
In the past, providers had to use an open surgery called pulmonary endarterectomy to remove blood clots and scar tissue from the lungs. This approach required a large incision through the chest and breastbone to access the lungs. With a balloon pulmonary angioplasty, an interventional cardiologist can remove blood clots without the large incision.
Balloon pulmonary angioplasty has similar long-term results as a pulmonary endarterectomy while offering the benefits of minimally invasive procedures, including a faster recovery, shorter hospital stay and less pain.
An experienced provider can perform a balloon pulmonary angioplasty with a low risk of complications. The rare potential risks of a balloon pulmonary angioplasty include:
- Blood vessel damage
- Injury to your lung tissue
- Hemoptysis, or coughing up blood
Balloon Pulmonary Angioplasty for CTEPH: The Penn Medicine Advantage
Penn interventional cardiologists are experts in a wide range of techniques to treat blood clots in the lungs. When you choose our team, you benefit from:
- Exclusive treatments: We are one of only a few teams in the nation with the expertise to offer balloon pulmonary angioplasty. We also have all the available FDA-approved technologies to remove blood clots or deliver medicines to dissolve them. It's rare to offer all these available devices.
- Team-based, expert care: Our Pulmonary Embolism Response Team (PERT) offers comprehensive, collaborative care for patients with pulmonary emboli. We were one of the first functioning PERTs in the country and are among the top 10 most advanced centers in the nation in pulmonary embolism treatment.
- Access to clinical trials: Penn has a long history of innovation, consistently offering the newest treatments before they're widely available. Our team continues to study new treatments, bringing you the latest leading-edge options such as balloon pulmonary angioplasty.
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