Balloon Pulmonary Angioplasty (BPA)

The University of Michigan Health Frankel Cardiovascular Center specializes in the treatment of chronic thromboembolic pulmonary hypertension (CTEPH), a condition in which there is high blood pressure in the arteries of the lungs caused by chronic blood clots that block the flow of blood through the lungs.

Patients with CTEPH are evaluated with thorough diagnostic testing. Depending on the amount and location of chronic blood clot material, treatment options may include a specialized surgery, a specialized balloon intervention procedure or medical therapy. We are the only center in Michigan to offer a specialized surgery for CTEPH known as pulmonary endarterectomy (PEA) and a specialized procedure known as balloon pulmonary angioplasty (BPA) to treat the condition. All patients with CTEPH take lifelong anticoagulation (blood thinning) medication to prevent additional clots from developing.

What is Balloon Pulmonary Angioplasty?

Balloon pulmonary angioplasty is an innovative therapy intended for CTEPH patients who are not candidates for PEA. BPA is a procedure that uses a balloon to open blood vessels that have been chronically narrowed or blocked. During the procedure, a deflated balloon is directed through a catheter to the diseased lung vessels where it is inflated to break up clots and restore blood flow to the lungs. The procedure helps reduce shortness of breath and increases activity tolerance.

Expert Evaluation

The Frankel CVC has unique expertise in treating patients with CTEPH. We are currently the only center in Michigan offering BPA to this patient population and one of the top five medical centers nationwide. The procedure is performed by our multidisciplinary team specially trained in this breakthrough intervention.

After careful examination, our expert team makes a recommendation for pulmonary endarterectomy, balloon pulmonary angioplasty or medical management — always with a focus on the optimal treatment plan for each patient.

What to Expect

  • BPA is performed in our state-of-the-art cardiac catheterization lab where a balloon catheter is used to open up the smaller branches of the pulmonary arteries that often can’t be reached through a pulmonary endarterectomy.
  • Patients are given a local anesthesia and mild sedative, but are awake during the procedure, which typically lasts between two and four hours.
  • BPA is performed in a series of four to eight procedures, depending on the patient’s condition. In most cases, two BPA procedures are performed two weeks apart, with subsequent treatments scheduled one to three months afterward. The total number of treatments and timing may vary from patient to patient.
  • During the minimally invasive treatment, a long, thin 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. With the help of X-ray images, a wire is then guided through the vessels and a deflated balloon is directed to the site of blockage. The balloon is inflated to press the clots against the walls of the arteries, opening a pathway and restoring blood flow. The balloon is then deflated and removed. Multiple vessels are treated during each BPA procedure and patients are typically discharged the next day. 

Involvement in Clinical Trials

University of Michigan Health has been involved in many clinical trials focused on new treatment options for pulmonary hypertension. We lead the state in experience and volume of currently enrolling clinical trials, and our physicians are often in leadership roles on these studies.

Our research gives patients direct access to the latest therapies to treat and manage pulmonary hypertension. U-M Health also serves as the Data Coordinating Center for the Pulmonary Hypertension Breakthrough Initiative, a network of multidisciplinary, collaborative transplant and research centers that distributes stored clinical specimens and relevant data to researchers for use in groundbreaking initiatives to better understand pulmonary arterial hypertension.

Make an Appointment

To make an appointment to discuss treatment for pulmonary embolism or CTEPH, call the University of Michigan Cardiovascular Call Center at 888-287-1082 or visit our Make a Cardiovascular Appointment page, where you can earn what to expect when you call us.