News | Pulmonary Embolism | October 23, 2018

First Balloon Pulmonary Angioplasty for Chronic Pulmonary Embolism Performed in Illinois

Northwestern Memorial Hospital becomes one of few centers in the United States offering novel procedure

First Balloon Pulmonary Angioplasty for Chronic Pulmonary Embolism Performed in Illinois

October 23, 2018 — Daniel J. Schimmel, Jr., M.D., MS, a cardiologist at Northwestern Memorial Hospital, recently performed the first balloon pulmonary angioplasty (BPA) to treat a pulmonary embolism in the state of Illinois.

Local doctors had found blood clots in the lungs of Sherry Seals, which would typically be treated with medication that would allow a return to a normal lifestyle. But her chest pain and shortness of breath worsened over time. She was referred to Northwestern Memorial Hospital with a much more serious diagnosis of pulmonary hypertension, a progressively worsening condition where high pressure in the arteries of the lungs can cause failure of the right side of the heart.

Northwestern physicians discovered that despite treatment with medication, the clots in her lungs were not dissolving, leading to a potentially fatal diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH).

Seals had too many clots spread too widely throughout her lungs to safely undergo surgery, the traditional method for removing the clots. At Northwestern, Seals became one of the first patients to undergo a series of BPAs, a novel technique for treating the condition for patients who cannot undergo surgery.

Schimmel, Jr. performed this new technique after training in Japan under the doctor who perfected it.

BPA is similar to coronary angioplasty, a common procedure where a balloon is used to widen blocked or narrow coronary arteries. While Seals was under local anesthetic, Schimmel threaded a narrow tube through the femoral vein in her leg, through the chambers of the heart, to allow staged treatment of the lung arterial segments.

Treatments are performed with various sized balloons ranging from 1.5 to 6 mm in diameter, inflated in the narrow vessels in the lungs to restore them to their normal size. The balloon widens the vessel, restoring blood flow to the lungs and lowering the high pressure in the lungs closer to normal. Contrast dye and X-rays are used to identify the blockage for the physician in real time during the procedure.

Schimmel performed a series of five BPAs on Seals between February and April 2018.

“For the first two procedures, the goal is not to expand the artery to normal, but to get the lung tissue used to seeing blood flow again,” he said. “If the lung tissue sees too much flow too fast, it can create injury. Follow-up procedures are meant to restore the artery to its normal size and return pressure in the lungs to normal. Patients often are not back to normal but start to feel improvement after the second procedure.”

Seals said after the second treatment, she noticed a marked difference in how she felt.

“I didn’t care if this was a new procedure, I just wanted to feel good again,” said Seals. “After each procedure I was breathing a little better.”

Now, Seals and her family are breathing a sigh of relief. She lives on the second floor, and was previously so winded it was difficult to walk to her home. When she previously needed to stop after half a block to catch her breath, she now can walk 12 blocks continuously.

“I can flip through the stairs, jump down, walk up, do it three times in a row if I was allowed to,” Seals said. “I am breathing so much better.”

Schimmel, who is also an assistant professor of medicine – cardiology at Northwestern University Feinberg School of Medicine, said his goal for patients is a return to a “normal quality of life.” His goal for himself and other early adopters of this technique is “to perfect the procedure. Some patients respond well to medication, and there are some new investigational drugs being tested. Other patients are candidates for BPA, but others may need an operation. BPA isn’t the right treatment for everyone, but in some cases it can be a game changer.”

Northwestern Memorial Hospital is the only hospital in Illinois offering BPA as treatment for CTEPH, along with surgical removal of clots, known as pulmonary endarterectomy (PEA), a procedure done by S. Chris Malaisrie, M.D., a cardiac surgeon at Northwestern. Both treatments are offered through Northwestern Medicine’s Pulmonary Vascular Disease Program, the only program in Illinois that has received accreditation from the Pulmonary Hypertension Association (PHA) as a Comprehensive Care Center. That is the highest level of recognition offered to medical centers that treat patients with pulmonary hypertension, a debilitating disease of the lungs that affects the functioning of the heart and can lead to heart failure.

“Northwestern now offers leading-edge treatments for patients with CTEPH including PEA, BPA and pulmonary vasodilators, medications that open narrowed blood vessels,” said Stuart Rich, MD, director of the Pulmonary Vascular Disease Program at Northwestern and a professor of medicine – cardiology at Feinberg. “As our experience has grown, we are beginning to consider combining all three of these approaches in a patient to personalize the treatments for the best outcomes.”

For more information: www.heart.nm.org

Related Content

Gallery | Cath Lab | October 31, 2019
This is a photo essay of the interventional cardiology and structural heart technologies on the expo floor and discus
The Alphenix Aero Package from Canon Medical Systems USA, Inc. enables OBLs and ASCs to attain premium technology at a flexible price point by tailoring Canon Medical’s Alphenix systems to fit their facilities’ needs.

The Alphenix Aero Package from Canon Medical Systems USA, Inc. enables OBLs and ASCs to attain premium technology at a flexible price point by tailoring Canon Medical’s Alphenix systems to fit their facilities’ needs.

Technology | Cath Lab | October 28, 2019
Office based labs (OBLs) and ambulatory surgery centers (ASCs) require a fresh perspective from imaging vendors.
Marco Costa, M.D., Ph.D., MBA, president, UH Harrington Heart and Vascular Institute, performing a cath lab procedure.

Marco Costa, M.D., Ph.D., MBA, president, UH Harrington Heart and Vascular Institute, performing a cath lab procedure.

News | Cath Lab | October 28, 2019
October 28, 2019 — Leaders within University Hospitals and the Harrington Heart and Vascular Institute had a vision t
OmniVision Announces Guinness World Record for Smallest Image Sensor

OmniVision's OVM6948 CameraCubeChip, a fully packaged, wafer-level camera module measuring 0.65mm x 0.65mm x 1.158mm, built on OmniVision's OV6948, winner of the Guinness World Record for “The Smallest Image Sensor Commercially Available.”

News | Cath Lab | October 22, 2019
October 22, 2019 — OmniVision Technologies Inc.
People watch the presentation of the five-year EXCEL Trial data by Gregg Stone, M.D., live in the Abbott booth at TCT 2019. Abbott makes the Xience stent used in the trial, which compared equally with long term surgical outcomes. #TCT2019

People watch the live presentation of the five-year EXCEL Trial data by Gregg Stone, M.D., in the Abbott booth at TCT 2019. Abbott makes the Xience stent used in the trial, which compared equally with long-term CABG surgical outcomes. 

Feature | Cath Lab | October 03, 2019
October 3, 2019 – Five-year data from the EXCEL Trial showed patients with left main coronary disease treated with pe
Two Stents Implanted in Democratic Presidential Candidate Bernie Sanders, suffers chest pain
News | Cath Lab | October 02, 2019 | Dave Fornell, Editor
October 2, 2019 — Democratic presidential candidate Sen.
Bypass Surgery and Coronary Stenting Yield Comparable 10-Year Survival
News | Cath Lab | September 25, 2019
Ten-year survival rates are similar for bypass surgery and coronary stenting with drug-eluting stents in randomized...
Complete Revascularization Superior to Culprit Lesion-only Intervention
News | Cath Lab | September 10, 2019
An international randomized trial has shown that complete revascularization reduces major cardiovascular events...
The cath lab staff UH Portage Medical Center.

The cath lab staff UH Portage Medical Center.

Feature | Cath Lab | September 09, 2019 | Anjan Gupta, M.D., FACC, FSCAI
Primary percutaneous coronary intervention (PCI) is the preferred treatment for acute...
Overlay Init