TY - JOUR
T1 - Successful depiction of systemic collateral supply to pulmonary artery in CTEPH using time-resolved 4D CT angiography
T2 - a case report
AU - Tamura, Masashi
AU - Kawakami, Takashi
AU - Yamada, Yoshitake
AU - Kataoka, Masaharu
AU - Nakatsuka, Seishi
AU - Fukuda, Keiichi
AU - Jinzaki, Masahiro
N1 - Publisher Copyright:
© The Author(s) 2020.
PY - 2020/4
Y1 - 2020/4
N2 - 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.
AB - 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.
KW - computed tomography angiography
KW - four-dimensional computed tomography
KW - pulmonary embolism
KW - pulmonary hypertension
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U2 - 10.1177/2045894019881065
DO - 10.1177/2045894019881065
M3 - Article
AN - SCOPUS:85083561138
VL - 10
JO - Pulmonary Circulation
JF - Pulmonary Circulation
SN - 2045-8932
IS - 2
ER -