Successful depiction of systemic collateral supply to pulmonary artery in CTEPH using time-resolved 4D CT angiography: a case report

A 49-year-old man with CTEPH (pre-procedural mean pulmonary artery pressure: 36 mmHg) underwent balloon pulmonary angioplasty. Chronic total occlusion of the left inferior pulmonary artery trunk was observed. To evaluate the collateral vessels of the chronic total occlusion, 4D-CTA was performed. The examination was performed using a 256-row detector CT system using the test bolus tracking method. 4D-CTA showed the bronchial artery-to-left inferior pulmonary artery collateral supply, which was confirmed by a selective bronchial artery angiography. The patient’s symptoms improved with balloon pulmonary angioplasty of the other stenotic lesions. 4D-CTA can noninvasively evaluate the anatomy and hemodynamics of multiple systemic collaterals simultaneously. This technique can support interventions in systemic artery-to-pulmonary artery collaterals, such as embolization, and could be helpful in challenging balloon pulmonary angioplasty interventions for chronic total occlusion to identify vessel structures distal to the chronic total occlusion and collateral channels for a retrograde approach.

Read the full article online

Topics

Embolism
Pulmonary Embolism
Pulmonary Hypertension

Authors

Masashi Tamura, Takashi Kawakami, Yoshitake Yamada, Masaharu Kataoka, Seishi Nakatsuka, Keiichi Fukuda, Masahiro Jinzaki

Published in:

Pulmonary Circulation Vol 10 : No 2 cover image

April 2020

Pulmonary Circulation Vol 10 : No 2

View this journal

Our research platform is the world.

Through worldwide collaboration, we can begin to answer the question of a global disease.

Join the PVRI
standard-example-image.jpg