Balloon Pulmonary Angioplasty (BPA)

UC San Diego Health is a worldwide leader for treatment of chronic thromboembolic pulmonary hypertension (CTEPH) through pulmonary endarterectomy (PTE) surgery, balloon pulmonary angioplasty (BPA), and medical therapy. 

Our pulmonary vascular specialists perform the most BPA procedures in the country, with several done each week and more than 150 conducted since 2015.

What is BPA?

Balloon pulmonary angioplasty is an approach for CTEPH patients who are not good candidates for surgery or have residual pulmonary hypertension. BPA is a procedure that uses balloons to open blood vessels that have been chronically narrowed or blocked. This restores blood flow to the lungs, reduces shortness of breath, and increases exercise tolerance.

Expert Evaluation for BPA

Our specialists are leading experts in evaluating patients with CTEPH. Our team evaluates patients based on a review of their medical records and several tests performed at UC San Diego Health. After a patient completes the examination, our team will recommend whether PTE, BPA, or medical therapy is the best treatment.  

About the BPA Procedure

The procedure is performed in our cardiac catheterization lab by a multidisciplinary team specially trained in this intervention. Patients receive local anesthesia and moderate sedation but are still awake. A long, thin tube called a catheter is inserted into the artery through the neck or groin and a second hollow tube is introduced through the catheter and passed to the diseased lung vessels.

The team takes X-ray images and measures pressures in the narrowed vessels. A thin wire is guided through the vessels and a deflated balloon is directed to the site of blockage. The balloon is inflated to disrupt the chronic blood clots and press the clots to the walls of the arteries. This opens a pathway and restores blood flow. The balloon is then deflated and removed. Multiple vessels are treated during each BPA procedure.

 

Before BPA Intervention

After BPA Intervention

 

How Long Will BPA Take?

Each BPA procedure takes approximately two to four hours. To adequately treat CTEPH, most patients require four to six separate BPA procedures. Often, two procedures are performed over two weeks and patients return in one to three months for subsequent treatments. The total number of treatments and timing may vary from patient to patient. Following BPA, patients typically spend one night in the hospital for observation and are discharged the next day.

Follow-up

Patients generally follow up with their referring physician and return back to UC San Diego Health in one to three months for more treatment sessions, if needed.