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Unexpected Acceleration in Treprostinil Delivery Administered by a Lenus Pro® Implantable Pump in Two Patients Treated for Pulmonary Arterial Hypertension

Intravenous treprostinil administration by an implantable pump is an attractive option for pulmonary arterial hypertension (PAH) treatment and is the subject of recent publications. Short-term studies are promising, but there is still a lack of long-term prospective data. We analyzed the treprostini...

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Autores principales: Kopp, Garance, Hachulla, Anne-Lise, Noble, Stéphane, Bringard, Aurélien, Soccal, Paola M., Beghetti, Maurice, Lador, Frédéric
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7662390/
https://www.ncbi.nlm.nih.gov/pubmed/33195292
http://dx.doi.org/10.3389/fmed.2020.539707
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author Kopp, Garance
Hachulla, Anne-Lise
Noble, Stéphane
Bringard, Aurélien
Soccal, Paola M.
Beghetti, Maurice
Lador, Frédéric
author_facet Kopp, Garance
Hachulla, Anne-Lise
Noble, Stéphane
Bringard, Aurélien
Soccal, Paola M.
Beghetti, Maurice
Lador, Frédéric
author_sort Kopp, Garance
collection PubMed
description Intravenous treprostinil administration by an implantable pump is an attractive option for pulmonary arterial hypertension (PAH) treatment and is the subject of recent publications. Short-term studies are promising, but there is still a lack of long-term prospective data. We analyzed the treprostinil flow rate administered by the Lenus Pro® implantable pump in 2 patients suffering from PAH during follow-up times of respectively 4.2 and 3 years. The flow rate delivered by the pumps in these 2 patients exceeded the manufacturer admitted margin of error within 2 years and continued to increase to reach, respectively, 158 and 120% of the expected flow rate at the end of the follow up. In one case, the implantable pump had to be removed for this reason. The ex-vivo flow rate of the withdrawn pump determined in the laboratory reached 173% of the predicted value. This correlated with the in-vivo measurement, which suggests a continuous flow increase even after pump removal and without treprostinil use. Spontaneous flow increase from such an implantable pump is a potentially major pitfall, which needs to be identified and actively managed by the responsible clinicians.
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spelling pubmed-76623902020-11-13 Unexpected Acceleration in Treprostinil Delivery Administered by a Lenus Pro® Implantable Pump in Two Patients Treated for Pulmonary Arterial Hypertension Kopp, Garance Hachulla, Anne-Lise Noble, Stéphane Bringard, Aurélien Soccal, Paola M. Beghetti, Maurice Lador, Frédéric Front Med (Lausanne) Medicine Intravenous treprostinil administration by an implantable pump is an attractive option for pulmonary arterial hypertension (PAH) treatment and is the subject of recent publications. Short-term studies are promising, but there is still a lack of long-term prospective data. We analyzed the treprostinil flow rate administered by the Lenus Pro® implantable pump in 2 patients suffering from PAH during follow-up times of respectively 4.2 and 3 years. The flow rate delivered by the pumps in these 2 patients exceeded the manufacturer admitted margin of error within 2 years and continued to increase to reach, respectively, 158 and 120% of the expected flow rate at the end of the follow up. In one case, the implantable pump had to be removed for this reason. The ex-vivo flow rate of the withdrawn pump determined in the laboratory reached 173% of the predicted value. This correlated with the in-vivo measurement, which suggests a continuous flow increase even after pump removal and without treprostinil use. Spontaneous flow increase from such an implantable pump is a potentially major pitfall, which needs to be identified and actively managed by the responsible clinicians. Frontiers Media S.A. 2020-10-30 /pmc/articles/PMC7662390/ /pubmed/33195292 http://dx.doi.org/10.3389/fmed.2020.539707 Text en Copyright © 2020 Kopp, Hachulla, Noble, Bringard, Soccal, Beghetti and Lador. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Kopp, Garance
Hachulla, Anne-Lise
Noble, Stéphane
Bringard, Aurélien
Soccal, Paola M.
Beghetti, Maurice
Lador, Frédéric
Unexpected Acceleration in Treprostinil Delivery Administered by a Lenus Pro® Implantable Pump in Two Patients Treated for Pulmonary Arterial Hypertension
title Unexpected Acceleration in Treprostinil Delivery Administered by a Lenus Pro® Implantable Pump in Two Patients Treated for Pulmonary Arterial Hypertension
title_full Unexpected Acceleration in Treprostinil Delivery Administered by a Lenus Pro® Implantable Pump in Two Patients Treated for Pulmonary Arterial Hypertension
title_fullStr Unexpected Acceleration in Treprostinil Delivery Administered by a Lenus Pro® Implantable Pump in Two Patients Treated for Pulmonary Arterial Hypertension
title_full_unstemmed Unexpected Acceleration in Treprostinil Delivery Administered by a Lenus Pro® Implantable Pump in Two Patients Treated for Pulmonary Arterial Hypertension
title_short Unexpected Acceleration in Treprostinil Delivery Administered by a Lenus Pro® Implantable Pump in Two Patients Treated for Pulmonary Arterial Hypertension
title_sort unexpected acceleration in treprostinil delivery administered by a lenus pro® implantable pump in two patients treated for pulmonary arterial hypertension
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7662390/
https://www.ncbi.nlm.nih.gov/pubmed/33195292
http://dx.doi.org/10.3389/fmed.2020.539707
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