{"id":"96d816c75444","type":"article","url":"https://hartvaat.nl/2020/08/25/pulmonale-arterie-denervatie-bij-residuele-ph-na-endarterectomie/","title":"Pulmonale arterie denervatie bij residuele PH na endarterectomie","title_en":"Pulmonary Artery Denervation for Patients With Residual Pulmonary Hypertension After Pulmonary Endarterectomy.","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog"],"tags":[],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2020.06.064","source_url":"https://doi.org/10.1016/j.jacc.2020.06.064","authors":["Alexander Romanov","Alexander Cherniavskiy","Nataliya Novikova","Alexander Edemskiy","Dmitry Ponomarev","Vitaliy Shabanov","Denis Losik","Dmitry Elesin","Ilya Stenin","Igor Mikheenko","Roman Zhizhov","Evgeny Kretov","Evgeny Pokushalov","Sunny S Po","Tamila V Martynyuk","Jonathan S Steinberg"],"significance":6,"published":"2020-08-25","source_date":"2020-08-25","image":"","kennis":[],"congress":"","summary_en":"This study evaluated pulmonary artery denervation for patients with residual pulmonary hypertension after pulmonary endarterectomy, testing whether catheter-based sympatholysis can improve hemodynamics in persistent CTEPH.","created":"2026-07-03T10:28:44Z","updated":"2026-07-03T13:27:53Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie naar pulmonale arterie denervatie bij patiënten met residuele pulmonale hypertensie na pulmonale endarterectomie.","abstract_original":"BACKGROUND: Pulmonary artery denervation (PADN) procedure has not been applied to patients with residual chronic thromboembolic pulmonary hypertension (CTEPH) after pulmonary endarterectomy (PEA). OBJECTIVES: This study sought to assess the safety and efficacy of PADN using remote magnetic navigation in patients with residual CTEPH after PEA. METHODS: Fifty patients with residual CTEPH despite medical therapy at least 6 months after PEA, who had mean pulmonary artery pressure ≥25 mm Hg or pulmonary vascular resistance (PVR) > 400 dyn‧s‧cm-5 based on right heart catheterization were randomized to treatment with PADN (PADN group; n = 25) using remote magnetic navigation for ablation or medical therapy with riociguat (MED group; n = 25). In the MED group, a sham procedure with mapping but no ablation was performed. The primary endpoint was PVR at 12 months after randomization. Key secondary endpoint included 6-min walk test. RESULTS: After PADN procedure, 2 patients (1 in each group) developed groin hematoma that resolved without any consequences. At 12 months, mean PVR reduction was 258 ± 135 dyn‧s‧cm-5 in the PADN group versus 149 ± 73 dyn‧s‧cm-5 in the MED group, mean between-group difference was 109 dyn‧s‧cm-5 (95% confidence interval: 45 to 171; p = 0.001). The 6-min walk test distance was significantly increased in the PADN group as compared to distance in the MED group (470 ± 84 m vs. 399 ± 116 m, respectively; p = 0.03). CONCLUSIONS: PADN in patients with residual CTEPH resulted in substantial reduction of PVR at 12 months of follow-up, accompanied by improved 6-min walk test."}