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Balloon pulmonary angioplasty and Riociguat in the management of chronic thromboembolic pulmonary hypertension: a systematic review

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dc.contributor.authorCamões De Araújo, Patrícia
dc.contributor.authorCalé, Rita
dc.contributor.authorPereira, Ernesto
dc.contributor.authorFerreira, Filipa
dc.contributor.authorAlegria, Sofia
dc.contributor.authorPereira, Helder
dc.contributor.authorCoelho, André
dc.date.accessioned2025-07-03T10:52:21Z
dc.date.available2025-07-03T10:52:21Z
dc.date.issued2025
dc.description© 2025 Published by Elsevier Ltd.pt_PT
dc.description.abstractBackground: No systematic review has been published comparing the effectiveness and safety of balloon pulmonary angioplasty (BPA) and riociguat in patients with chronic thromboembolic pulmonary hypertension (CTEPH) across studies that evaluate both treatment methods. Methods: A literature search was conducted using PubMed, ScienceDirect, and Elsevier. Clinical, functional, and hemodynamic effectiveness criteria were analysed, as well as complications related to both interventions. Results: Five studies were reviewed, including randomized clinical trials and observational studies, comprising a total of 184 patients who underwent riociguat and BPA, 94 patients who underwent BPA alone, and 79 who underwent riociguat alone. Patients receiving combination therapy demonstrated a more significant improvement in WHO-FC, PVR, and CO (≈1.13 L/min) compared to monotherapy (BPA: ≈0.45 L/min and riociguat: ≈0.84 L/min). Regarding the 6MWD, patients who started with Riociguat before combination therapy showed a greater improvement (≈78 m) than those on monotherapy (BPA: ≈46.9 m and riociguat: ≈38.2 m). The reduction in mPAP was greater in patients treated with BPA alone (≈-17.6 mmHg) compared to riociguat alone (≈-5.4 mmHg) or combination therapy (≈-12.2 mmHg). In the BPA group, the rate of life-threatening complications was very low, with haemoptysis or pulmonary haemorrhage being the most common adverse events (15 %-44 %). In the riociguat group, dizziness, headaches, gastrointestinal reflux, vomiting, and nausea were reported (15 %-23 %). Among patients undergoing both treatments, the vascular injury rate was <11 %, with the most common adverse event being the need for non-invasive ventilation (30 %). Conclusions: Combination therapy appears to be more effective than monotherapy, without being associated to major adverse events in patients diagnosed with CTEPH.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRespir Med. 2025 Aug:244:108154pt_PT
dc.identifier.doi10.1016/j.rmed.2025.108154pt_PT
dc.identifier.eissn1532-3064
dc.identifier.issn0954-6111
dc.identifier.urihttp://hdl.handle.net/10400.5/102002
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relation.publisherversionhttps://www.sciencedirect.com/journal/respiratory-medicinept_PT
dc.subjectBalloon pulmonary angioplastypt_PT
dc.subjectChronic thromboembolic pulmonary hypertensionpt_PT
dc.subjectEffectivenesspt_PT
dc.subjectPulmonary vasodilator therapypt_PT
dc.subjectSafetypt_PT
dc.titleBalloon pulmonary angioplasty and Riociguat in the management of chronic thromboembolic pulmonary hypertension: a systematic reviewpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleRespiratory Medicinept_PT
oaire.citation.volume244pt_PT
person.familyNameCamões de Araújo
person.familyNameCalé
person.familyNameAlegria
person.familyNamePereira
person.givenNamePatrícia
person.givenNameRita
person.givenNameSofia
person.givenNameHelder
person.identifier.ciencia-idA813-F379-0425
person.identifier.ciencia-id1D1D-DBAB-FAD4
person.identifier.orcid0000-0002-5640-7518
person.identifier.orcid0000-0002-6719-2065
person.identifier.orcid0000-0002-8745-3541
person.identifier.orcid0000-0001-8656-4883
person.identifier.ridB-6870-2014
person.identifier.scopus-author-id25824692500
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationcc884798-8331-411e-ab10-a822b1e932cd
relation.isAuthorOfPublication99d1c401-44f9-4688-af11-d3d378335d21
relation.isAuthorOfPublication11a1e6ae-6e41-4103-8dc8-95ebab37ca4e
relation.isAuthorOfPublicationf61e1990-9af4-4cdc-a0d4-c4f17fd69f15
relation.isAuthorOfPublication.latestForDiscovery11a1e6ae-6e41-4103-8dc8-95ebab37ca4e

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