Drug-Eluting Balloons Versus Conventional Balloon Angioplasty for Peripheral Pulmonary Artery Stenosis in Childhood

The objective of this study was to evaluate the efficacy of drug-eluting balloons angioplasty (DEBA) compared with conventional balloon angioplasty (CBA) in children with peripheral pulmonary artery stenoses (PAS). PAS is a common complication in children with congenital heart defects (for example tetralogy of Fallot), postoperative patients, and certain syndromes (Alagille, Noonan, Williams-Beuren). A retrospective qualitative analysis was performed of the individual stenoses, which were treated by dilation via cardiac catheterization and controlled after several months. The study involved 103 stenoses from 2012 to 2022 whose diameters were measured at the initial and at follow-up catheterization. The intervention group (DEBA) was compared with the control group (CBA) in terms of lumen diameter change, hemodynamics, and infant development. During mean follow-up period of 10.2 ± 8.1 months, the diameter growth rate was significantly higher in patients treated with DEB (diameter growth/month: 0.151 ± 0.103 mm vs. 0.087 ± 0.032 mm, p = < .001; fractional diameter growth/month: 4.1 ± 3% vs. 2.2 ± 1.2%, p = < .001). The right ventricular load, which is represented by the ratio of systolic right ventricular pressure and systolic systemic arterial pressure, was significantly reduced in DEB-treated stenoses (RV-SA pressure ratio change: - 6.4 ± 12.4% vs. 4.3 ± 22.2%, p = .023). This study demonstrated that DEB for treatment of PAS was effective and resulted in a higher lumen increase of the affected vessel than the treatment with conventional balloons.