Emerging Role of Balloon Pulmonary Angioplasty in Chronic Thromboembolic Pulmonary Disease—Insights from the 2022 ESC Guidelines

This excellent review summarizes the existing evidence for use of balloon pulmonary angioplasty (BPA) based on the 2022 European Society of Cardiology and European Respiratory Society (ESC/ERS) guidelines and discusses the safety, efficacy, and its current role in relation to the more established pulmonary endarterectomy (PEA) and existing best medical therapies. 

ESC/ERS updated their guidelines for BPA from IIb-C in 2015 to I-B in 2022 and recognized the role of BPA, not as a replacement for PEA/medical therapy, but as both an adjunct and as standalone therapy in cases where PEA may not be applicable because of prohibitive surgical risk. Given the relatively recent introduction of BPA and ongoing improvements in technique, guidelines and standards of care with regards to BPA continue to evolve.