Skip to main content Accessibility help

Recent results of pulmonary arterial angioplasty: the differences between proximal and distal lesions

  • Lisa Bergersen (a1), Kimberlee Gauvreau (a1), James E. Lock (a1) and Kathy J. Jenkins (a1)


Introduction: We sought to establish a modern understanding of the safety and efficacy of trans-catheter pulmonary arterial angioplasty. Methods: A review of records in a sample of 104 dilations, out of a total of 711 procedures undertaken between January, 1996 and December, 2000, provided descriptive information regarding technique, adverse events, and changes achieved in luminal diameter. Because evidence during the review of angiograms suggested substantial differences according to whether the stenotic lesions were positioned proximally or distally within the pulmonary arterial tree, all analyses incorporated this classification. Results: We reviewed stenoses in 203 pulmonary arteries, 38% located proximally and 62% distally, with follow-up available concerning dilation in 92 vessels. Proximal dilations frequently involved a prior surgical site, and appeared more compliant and amenable to conventional angioplasty, as evidenced by more common elimination of the waist, but also more recoil, then requiring placement of stents. In contrast, distal lesions frequently required balloons capable of sustaining high pressures of inflation, and larger balloons relative to the size of the vessels. The proportional increase in diameter was greater for distal sites, at 90 plus or minus 77%, compared to proximal, at 64 plus or minus 70%, p equal to 0.002. Serious adverse events occurred in 3 of 104 procedures, giving a rate of serious adverse events of 2.9%. At follow-up, 9 of 92 vessels (10%), 95% confidence intervals from 5% to 18%, returned to their diameters prior to dilation, with no difference in the rate of restenosis according to the site of dilation. Conclusion: Our findings indicate the need to distinguish, and to consider, the important differences in technical issues and outcomes, when performing dilations at proximal as opposed to distal sites. Although angioplasty is effective therapy for pulmonary arterial stenosis, a subset of vessels, more often distal, remain resistant to conventional techniques.


Corresponding author

Correspondence to: Lisa Bergersen MD, Department of Cardiology, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA. Tel: +1 617 355 7893; Fax: +1 617 739 3784; E-mail:


Hide All


Lock J, Castaneda-Zuniga W, Fuhrman B, Bass J. Balloon dilation angioplasty of hypoplastic and stenotic pulmonary arteries. Circulation 1983; 67: 962967.
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: 10691073.
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: 11091117.
Kan J, Marvin W, Bass J, Muster A, Murphy J. Balloon angioplasty-branch pulmonary artery stenosis: Results from the valvuloplasty and angioplasty of congenital anomalies registry. Am J Cardiol 1990; 65: 798801.
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: 14671470.
Gentles T, Lock J, Perry S. High pressure balloon angioplasty for branch pulmonary artery stenosis: early experience. J Am Coll Cardiol 1993; 22: 867872.
Zeevi B, Berant M, Blieden L. Midterm clinical impact versus procedural success of balloon angioplasty for pulmonary artery stenosis. Pediatr Cardiol 1997; 18: 101106.
Bush DM, Hoffman TM, Del Rosario J, Eiriksson H, Rome JR. Frequency of restenosis after balloon pulmonary arterioplasty and its causes. Am J Cardiol 2000; 86: 12051209.
Baker C, McGowan F, Keane J, Lock J. Pulmonary artery trauma due to balloon dilation: recognition, avoidance and management. J Am Coll Cardiol 2000; 36: 16841690.
Rhodes JF, Lane GK, Mesia CI, et al. Cutting balloon angioplasty for children with small-vessel pulmonary artery stenoses. Catheter Cardiovasc Interv 2002; 55: 7377.
Bergersen L, Perry SB, Lock JE. Effect of cutting balloon angioplasty on resistant pulmonary artery stenosis. Am J Cardiol 2003; 91: 185189.
Sugiyama H, Vedtman GR, Norgard G, Lee KJ, Chaturvedi R, Benson LN. Bladed balloon angioplasty for peripheral pulmonary artery stenosis. Catheter Cardiovasc Interv 2004; 62: 7177.


Recent results of pulmonary arterial angioplasty: the differences between proximal and distal lesions

  • Lisa Bergersen (a1), Kimberlee Gauvreau (a1), James E. Lock (a1) and Kathy J. Jenkins (a1)


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed