Chronic Thromboembolic Pulmonary Hypertension, CTEPH
Conditions
Keywords
Balloon pulmonary angioplasty, BPA
Brief summary
The International Balloon Pulmonary Angioplasty (BPA) Registry is a prospective, multi-center, long-term observational project. Scheduled to start data collection in Q4 2017, the registry will run for approximately four years with a follow-up time for each patient of at least two years. Its primary objective is to investigate the efficacy and safety of BPA intervention in patients with chronic thromboembolic pulmonary hypertension (CTEPH) not amenable to pulmonary endarterectomy (PEA).
Interventions
PROCEDUREBalloon pulmonary angioplasty
BPA is an interventional technique where a balloon catheter is used to recanalize affected segments of pulmonary arteries identified during angiography.
Sponsors
International CTEPH Association
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Diagnosis with CTEPH according to the following criteria: * Mean PAP ≥ 25mmHg at rest; or if mean PAP \< 25mmHg at rest, have exercise limitations from chronic thromboembolic disease * Abnormal ventilation perfusion lung scanning (VQ) scan, pulmonary angiogram, computer tomographic pulmonary angiogram, or magnetic resonance pulmonary angiogram confirming chronic thromboembolic disease as recommended by standard guidelines * Treatment with anticoagulation for ≥ 3 months before diagnosis of CTEPH * Naïve to BPA treatment * Scheduled to undergo their first BPA session ≥ 1 day after enrollment. Enrollment is defined as date the consent is signed by the patient. Enrollment must occur before any BPA session * Willing to provide informed consent
Exclusion criteria
* BPA treatment prior to enrollment * Pulmonary hypertension cause other than World Health Organization (WHO) group IV (CTEPH) * Targeted BPA treatment lesion other than from WHO group IV (CTEPH)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Safety as assessed by BPA-associated complications | Min. 2 years | — |
| Efficacy as assessed by change in PVR | Min. 2 years | Change in pulmonary vascular resistance (PVR) from baseline to latest post-interventional follow-up hemodynamics |
| Efficacy as assessed by change in mPAP | Min. 2 years | Change in mean pulmonary arterial pressure (mPAP) from baseline to latest post-interventional follow-up hemodynamics |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| At the end of follow-up, compare technical aspects of BPA as assessed by investigator-reported session goals | Min. 2 years | — |
| At the end of follow-up, compare technical aspects of BPA as assessed by number of sessions per patient and follow-up | Min. 2 years | — |
| At the end of follow-up, compare technical aspects of BPA as assessed by number of interventions per patient and follow-up | Min. 2 years | — |
| At the end of follow-up, compare technical aspects of BPA as assessed by technical limits | Min. 2 years | — |
| Compare volume of BPA cases across regions and case load at the end of recruitment | Min. 2 years | — |
| Analyze the use of PH targeted medical therapy after BPA | Min. 2 years | PH targeted therapy will be categorised as prostacyclin, IP agonist, PDE5 inhibitor, ERA, guanylate cyclase stimulator and other |
| Analyze the impact of PH targeted medical treatment on key patient outcomes | Min. 2 years | PH targeted therapy will be categorised as prostacyclin, IP agonist, PDE5 inhibitor, ERA, guanylate cyclase stimulator and other Key patient outcomes encompass WHO functional class, 6-minute-walk-distance, Borg dyspnoe score, haemodynamics and mortality |
| Health care resource use required to complete BPA | Min. 2 years | As assessed by total hospital days in/out |
| Analyze the use of PH targeted medical therapy before BPA | Min. 2 years | PH targeted therapy will be categorised as prostacyclin, IP agonist, PDE5 inhibitor, ERA, guanylate cyclase stimulator and other |
| Analyze patient selection criteria for BPA across sites at the end of recruitment | Min. 2 years | — |
| At the end of follow-up, compare technical aspects of BPA as asssed by imaging modalities as used by the sites | Min. 2 years | Imaging modalities encompass VQ scan, selective pulmonary angiogram, CT pulmonary angiogram, dual-energy CT, cone-beam CT, MRI, OCT and IVUS |
Countries
Austria, Belgium, Czechia, France, Germany, Japan, Netherlands, Poland, United Kingdom, United States
Outcome results
None listed