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BPA improves pulmonary hemodynamics, right ventricular function, exercise tolerance, and quality of life. Evidence from RACE and MR-BPA shows greater reductions in pulmonary vascular resistance and mean pulmonary arterial pressure than riociguat, with more procedure-related complications. Technique and imaging advances, imaging-guided patient selection, and expert guidance strengthen safety and support multimodal management, while ongoing work focuses on long-term outcomes and endpoint standardization.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/current-perspectives-on-balloon-pulmonary-angioplasty-for-chronic-thromboembolic-pulmonary-hypertension/461477/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/current-perspectives-on-balloon-pulmonary-angioplasty-for-chronic-thromboembolic-pulmonary-hypertension/461477.png","ImageObject",300,407,{"name":92,"@type":93},"Rainbow Cat","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-08","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Who benefits most from balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension?","Question",{"text":112,"@type":113},"BPA is used for patients with inoperable CTEPH, particularly those with distal pulmonary artery lesions or significant comorbidities that preclude pulmonary endarterectomy.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How does balloon pulmonary angioplasty compare with riociguat based on randomized trials?",{"text":117,"@type":113},"Recent randomized controlled trials indicate BPA produces greater reductions in pulmonary vascular resistance and mean pulmonary arterial pressure than riociguat, though it has a higher incidence of procedure-related complications.",{"name":119,"@type":110,"acceptedAnswer":120},"What key advances have improved BPA safety?",{"text":121,"@type":113},"Advances in procedural techniques, imaging guidance, and patient selection have substantially enhanced the safety profile of BPA.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},461477,1790791483,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":36},962090769181,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Review  \nCurrent Perspectives on Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension  \nHyungdon Kook 1, Woohyeun Kim 1, Ran Heo 1, Kyunam Kim 2, Seung-Jin Yoo 3, Hyunsoo Kim 4, Dong Won Park 5 and Young-Hyo Lim 1, *  \n1 Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University,  \n222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea; [cvkook@hanyang.ac.kr](cvkook@hanyang.ac.kr) (H.K.); [coincidence1@naver.com](coincidence1@naver.com) (W.K.)  \n2 Department of Anesthesiology and Pain Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea; [knkim9@hanyang.ac.kr](knkim9@hanyang.ac.kr)  \n3 Department of Radiology, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea  \n4 Department of Thoracic and Cardiovascular Surgery, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea  \n5 Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea; [dongwonpark@hanyang.ac.kr](dongwonpark@hanyang.ac.kr)  \n* [Correspondence: mdoim@hanyang.ac.kr](Correspondence: mdoim@hanyang.ac.kr); Tel.: +82-2-2290-8309  \nAbstract  \nBalloon pulmonary angioplasty (BPA) has become an established treatment modality for patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH), particularly in those with distal pulmonary artery lesions or significant comorbidities precluding pulmonary endarterectomy. BPA provides significant improvement in pulmonary hemodynamics, right ventricular function, exercise tolerance, and quality of life. Recent randomized controlled trials, including the RACE and MR-BPA trials, have demonstrated that BPA results in greater reduction in pulmonary vascular resistance and mean pulmonary arterial pressure compared to riociguat, although with a higher incidence of procedurerelated complications. Ancillary follow-up data further suggest that a sequential strategy combining medical therapy and BPA may optimize outcomes and reduce adverse events. Advances in procedural techniques, imaging guidance, and patient selection have substantially improved the safety profile of BPA. International registries and expert consensus guidelines now support its incorporation into the multimodal management of CTEPH. This review synthesizes current evidence on the efficacy, safety, and practical aspects of BPA, while highlighting ongoing challenges, including long-term outcome data, standardization of treatment endpoints, and the role of combination therapy. BPA is poised to play an increasingly central role in personalized care strategies for CTEPH.  \nAcademic Editor: Michele Correale  \nReceived: 24 November 2025  \nRevised: 15 December 2025  \nAccepted: 18 December 2025  \nPublished: 21 December 2025  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \nKeywords: chronic thromboembolic pulmonary hypertension; balloon pulmonary angioplasty; pulmonary endarterectomy; riociguat; pulmonary hypertension  \n1. Introduction  \nChronic thromboembolic pulmonary hypertension (CTEPH) is a progressive form of pulmonary hypertension caused by unresolved, organized thrombi in pulmonary arteries and secondary arteriopathy that leads to elevated pulmonary vascular resistance (PVR) and right ventricular failure [1] . Epidemiological studies estimate the prevalence of CTEPHat roughly 26–38 cases per million and an incidence of 3–5 cases per million adults per year,  \nalthough precise numbers are difficult to establish due to under-recognition and misdiagnosis [2,3] . CTEPH develops in approximately 3–4% of patients after an episode of acute pulmonary embolism despite adequate anticoagulation [4] . The gold standard treatment is pulmonary endarterectomy (PEA), an open surgical procedure pe","cbCaibfFEnj7SELg","https://ap.wps.com/l/cbCaibfFEnj7SELg","pdf",2088699,16,"English","# Abstract\n# 1. Introduction\n## Chronic thromboembolic pulmonary hypertension and current management\n# 2. Pathophysiology of CTEPH","[{\"question\":\"Who benefits most from balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension?\",\"answer\":\"BPA is used for patients with inoperable CTEPH, particularly those with distal pulmonary artery lesions or significant comorbidities that preclude pulmonary endarterectomy.\"},{\"question\":\"How does balloon pulmonary angioplasty compare with riociguat based on randomized trials?\",\"answer\":\"Recent randomized controlled trials indicate BPA produces greater reductions in pulmonary vascular resistance and mean pulmonary arterial pressure than riociguat, though it has a higher incidence of procedure-related complications.\"},{\"question\":\"What key advances have improved BPA safety?\",\"answer\":\"Advances in procedural techniques, imaging guidance, and patient selection have substantially enhanced the safety profile of BPA.\"}]","Current Perspectives on Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension | PDF",1790761695]