Case Reports
Iloprost for Chronic Thromboembolic Pulmonary Hypertension
V. Roig Figueroa
, A. Herrero Pérez, N. de la Torre Ferrera, E. Hernández García, J.L. Aller Álvarez, J. Para Cabello
Corresponding author
vroig@usuarios.retecal.es
Correspondence: Dr. V. Roig Figueroa. Hernando de Acuña, 41 bis, 2.° A. 47014 Valladolid. España
Correspondence: Dr. V. Roig Figueroa. Hernando de Acuña, 41 bis, 2.° A. 47014 Valladolid. España
Servicio de Neumología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
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Roig Figueroa, A. Herrero Pérez, N. de la Torre Ferrera, E. Hernández García, J.L. Aller Álvarez, J. Para Cabello" "autores" => array:6 [ 0 => array:5 [ "preGrado" => "Dr." "nombre" => "V." "apellidos" => "Roig Figueroa" "email" => array:1 [ 0 => "vroig@usuarios.retecal.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Herrero Pérez" ] 2 => array:2 [ "nombre" => "N." "apellidos" => "de la Torre Ferrera" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Hernández García" ] 4 => array:2 [ "nombre" => "J.L." "apellidos" => "Aller Álvarez" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Para Cabello" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Neumología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. V. Roig Figueroa. Hernando de Acuña, 41 bis, 2.° A. 47014 Valladolid. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-10-17" "fechaAceptado" => "2004-02-17" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec153511" "palabras" => array:3 [ 0 => "Iloprost" 1 => "Chronic thromboembolic pulmonary hypertension" 2 => "Thromboendarterectomy" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec153512" "palabras" => array:3 [ 0 => "Iloprost" 1 => "Hipertensión pulmonar tromboembólica crónica" 2 => "Tromboendarterectomía" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Chronic thromboembolic pulmonary hypertension (CTPH) is an uncommon complication of pulmonary embolism. The treatment of choice is thromboendarterectomy, a safe and effective surgical procedure in expert hands. However, a fair number of patients are not considered candidates for thromboendarterectomy or do not accept the risk involved. Such patients may respond well to prostacyclin or its derivatives. In recent years new vasodilator drugs administered by a variety of routes have appeared on the market. These drugs have been studied mainly for their effects on primary pulmonary hypertension or hypertension associated with connective-tissue diseases. Few trials have assessed their efficacy in patients with CTPH, however.</p><p class="elsevierStyleSimplePara elsevierViewall">We report 2 cases of CTPH in which thromboendarterectomy was rejected. Neither of the patients responded to the conventional treatment of anticoagulants, diuretics, calcium antagonists, and angiotensin-converting enzyme inhibitors, but they did respond very well clinically, hemodynamically, and functionally to an inhaled prostacyclin analog, iloprost. We discuss the effects of iloprost in patients with CTPH, its mechanism of action, and its use as a potential pharmacological alternative to thromboendarterectomy. We also discuss new pulmonary vasodilators in general.</p>" ] "es" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">La hipertensión pulmonar tromboembólica crónica (HTPTC) es una complicación infrecuente de la embolia pulmonar. El tratamiento de elección es la tromboendarterectomía, proceder quir úrgico seguro y eficaz en manos expertas. Un número no despreciable de pacientes, sin embargo, no se consideran candidatos a tromboendarterectomía o no aceptan los riesgos de la intervención. Estos pacientes pueden presentar una evolución favorable con prostaciclina o sus derivados. En los últimos años han aparecido nuevos fármacos vasodilatadores que actúan por diversas vías y cuyos efectos se han estudiado fundamentalmente en la hipertensión pulmonar arterial primaria o asociada a conectivopatías; sin embargo, son escasas las referencias en cuanto a su eficacia en la HTPTC.</p><p class="elsevierStyleSimplePara elsevierViewall">Se presentan 2 casos de HTPTC en los que se desestimó la tromboendarterectomía y que no respondieron al tratamiento convencional con anticoagulantes, diuréticos, anta-gonistas del calcio e inhibidores de la enzima de conversión de la angiotensina; en cambio, presentaron una excelente respuesta clínica, hemodinámica y funcional al análogo de la prostaciclina iloprost por vía inhalatoria. Se comentan los efectos de los nuevos fármacos vasodilatadores pulmonares en general y del iloprost en particular en la HTPTC, su mecanismo de acción y su papel como posible alternativa farmacológica a la tromboendarterectomía.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:15 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic thromboembolic pulmonary hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "PF Fedullo" 1 => "WR Auger" 2 => "KM Kera" 3 => "LJ Rubin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "N Engl J Med" "fecha" => "2001" "volumen" => "345" "paginaInicial" => "1465" "paginaFinal" => "1472" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary endarterectomy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "SW Jamieson" 1 => "DP Kapelanski" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Curr Probl Surg" "fecha" => "2000" "volumen" => "37" "paginaInicial" => "165" "paginaFinal" => "252" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10723452" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic thromboembolic pulmonary hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "PF Fedullo" 1 => "WR Auger" 2 => "RN Channick" 3 => "KM Kerr" 4 => "LJ Rubin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Chest Med" "fecha" => "2001" "volumen" => "22" "paginaInicial" => "561" "paginaFinal" => "581" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11590849" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term results after thromboendarterectomy for chronic pulmonary embolism" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T Kramm" 1 => "E Mayer" 2 => "M Dahm" 3 => "S Guth" 4 => "T Menzel" 5 => "M Pitton" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Eur J Cardiothoracic Surg" "fecha" => "1999" "volumen" => "15" "paginaInicial" => "579" "paginaFinal" => "583" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Right ventricular pathology in chronic pulmonary hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "SP Bradley" 1 => "WR Auger" 2 => "KM Moser" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Cardiol" "fecha" => "1996" "volumen" => "78" "paginaInicial" => "584" "paginaFinal" => "587" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8806351" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Inhaled iloprost for severe pulmonary hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H Olchewsky" 1 => "G Simmoneau" 2 => "N Galié" 3 => "T Higenbottam" 4 => "R Naeije" 5 => "LJ Rubin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa020204" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2002" "volumen" => "347" "paginaInicial" => "322" "paginaFinal" => "329" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12151469" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bosentan therapy for pulmonary arterial hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "LJ Rubin" 1 => "DB Badesc" 2 => "RJ Barst" 3 => "N Galié" 4 => "CM Black" 5 => "A Keogh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa012212" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2002" "volumen" => "346" "paginaInicial" => "896" "paginaFinal" => "903" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11907289" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prostacyclin therapy before pulmonary thromboendarterectomy in patients with chronic thromboembolic pulmonary hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N Nagaya" 1 => "N Sasaki" 2 => "M Ando" 3 => "H Ogino" 4 => "F Sakamaki" 5 => "S Kyotany" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2003" "volumen" => "123" "paginaInicial" => "338" "paginaFinal" => "343" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12576349" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of orally active prostacyclin analogue on survival in patients with chronic thromboembolic pulmonary hypertension without major vessel obstruction" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F Ono" 1 => "N Nagaya" 2 => "H Okumura" 3 => "Y Shimizu" 4 => "S Kyotani" 5 => "N Nakanishi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Chest" "fecha" => "2003" "volumen" => "123" "paginaInicial" => "1583" "paginaFinal" => "1588" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Combination therapy with oral sildenafil and inhaled Iloprost for severe pulmonary hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "HA Ghofrani" 1 => "R Wiedemann" 2 => "F Rose" 3 => "H Olchewsky" 4 => "RT Schemuly" 5 => "N Weissmann" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Ann Intern Med" "fecha" => "2002" "volumen" => "136" "paginaInicial" => "515" "paginaFinal" => "522" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The use of inhaled aerosolized prostacyclin in the treatment of pulmonary hypertension secondary to pulmonary embolism" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "SA Webb" 1 => "S Stott" 2 => "PV van Heerden" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Intensive Care Med" "fecha" => "1996" "volumen" => "22" "paginaInicial" => "353" "paginaFinal" => "355" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8708174" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nuevos tratamientos médicos en la hipertensión pulmonar" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "MA Gómez Sánchez" 1 => "M Lázaro Salvador" 2 => "P Escribano Subias" 3 => "JF Delgado Jiménez" 4 => "R Tello de Meneses" 5 => "I Cea Calvo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2002" "volumen" => "38" "numero" => "Supl 1" "paginaInicial" => "29" "paginaFinal" => "32" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Influence of inhaled iloprost transpulmonary gradient of big endothelin patients with pulmonary hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H Wilkens" 1 => "M Bauer" 2 => "N Forestier" 3 => "J Konig" 4 => "A Eichler" 5 => "S Schneider" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Circulation" "fecha" => "2003" "volumen" => "107" "paginaInicial" => "1509" "paginaFinal" => "1523" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assessment of the vasodilator response in primary pulmonary hypertension. Comparing prostacyclin and iloprost administered by either infusion or inhalation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "CF Optiz" 1 => "R Wensel" 2 => "M Bettmann" 3 => "R Schaffarzyk" 4 => "M Linscheid" 5 => "R Hetzer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "2003" "volumen" => "24" "paginaInicial" => "356" "paginaFinal" => "365" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12581683" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nueva nomenclatura y clasificación de la hipertensión pulmonar" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "JA Barberá" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2002" "volumen" => "38" "numero" => "Supl 1" "paginaInicial" => "3" "paginaFinal" => "9" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000004000000007/v1_201305150100/S1579212906603108/v1_201305150100/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/15792129/0000004000000007/v1_201305150100/S1579212906603108/v1_201305150100/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906603108?idApp=UINPBA00003Z" ]
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| 2019 December | 12 | 11 | 23 |
| 2019 November | 10 | 7 | 17 |
| 2019 October | 4 | 6 | 10 |
| 2019 September | 9 | 22 | 31 |
| 2019 August | 9 | 5 | 14 |
| 2019 July | 5 | 12 | 17 |
| 2019 June | 6 | 15 | 21 |
| 2019 May | 6 | 14 | 20 |
| 2019 April | 17 | 19 | 36 |
| 2019 March | 8 | 13 | 21 |
| 2019 February | 7 | 10 | 17 |
| 2019 January | 2 | 11 | 13 |
| 2018 December | 10 | 8 | 18 |
| 2018 November | 16 | 5 | 21 |
| 2018 October | 17 | 12 | 29 |
| 2018 September | 7 | 8 | 15 |
| 2018 May | 3 | 0 | 3 |
| 2018 April | 8 | 6 | 14 |
| 2018 March | 4 | 3 | 7 |
| 2018 February | 5 | 7 | 12 |
| 2018 January | 8 | 6 | 14 |
| 2017 December | 6 | 7 | 13 |
| 2017 November | 5 | 8 | 13 |
| 2017 October | 5 | 5 | 10 |
| 2017 September | 2 | 5 | 7 |
| 2017 August | 6 | 8 | 14 |
| 2017 July | 3 | 5 | 8 |
| 2017 June | 9 | 14 | 23 |
| 2017 May | 7 | 10 | 17 |
| 2017 April | 2 | 7 | 9 |
| 2017 March | 2 | 6 | 8 |
| 2017 February | 0 | 1 | 1 |
| 2017 January | 1 | 4 | 5 |
| 2016 December | 11 | 10 | 21 |
| 2016 November | 15 | 8 | 23 |
| 2016 October | 29 | 17 | 46 |
| 2016 September | 10 | 8 | 18 |
| 2016 August | 5 | 5 | 10 |
| 2016 July | 9 | 5 | 14 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 32 | 1 | 33 |
| 2015 September | 24 | 9 | 33 |
| 2015 August | 16 | 9 | 25 |
| 2015 July | 23 | 5 | 28 |
| 2015 June | 25 | 6 | 31 |
| 2015 May | 42 | 5 | 47 |
| 2015 April | 30 | 8 | 38 |
| 2015 March | 30 | 11 | 41 |
| 2015 February | 32 | 3 | 35 |
| 2015 January | 19 | 8 | 27 |
| 2014 December | 17 | 6 | 23 |
| 2014 November | 29 | 5 | 34 |
| 2014 October | 37 | 11 | 48 |
| 2014 September | 29 | 5 | 34 |
| 2014 August | 30 | 4 | 34 |
| 2014 July | 24 | 9 | 33 |
| 2014 June | 41 | 7 | 48 |
| 2014 May | 30 | 10 | 40 |
| 2014 April | 53 | 11 | 64 |
| 2014 March | 48 | 11 | 59 |
| 2014 February | 42 | 9 | 51 |
| 2014 January | 33 | 11 | 44 |
| 2013 December | 40 | 12 | 52 |
| 2013 November | 38 | 10 | 48 |
| 2013 October | 32 | 8 | 40 |
| 2013 September | 35 | 8 | 43 |
| 2013 August | 39 | 12 | 51 |
| 2013 July | 43 | 12 | 55 |
| 2013 June | 30 | 7 | 37 |
| 2013 May | 24 | 5 | 29 |
| 2013 April | 21 | 3 | 24 |
| 2013 March | 6 | 2 | 8 |
Show all
