Evaluation of organized thrombus in distal pulmonary arteries in patients with chronic thromboembolic pulmonary hypertension using cone-beam computed tomography

Tetsuya Fukuda, Takeshi Ogo, Norifumi Nakanishi, Jin Ueda, Yoshihiro Sanda, Yoshiaki Morita, Munehiro Sugiyama, Shigefumi Fukui, Akihiro Tsuji, Hiroaki Naito

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)

Abstract

Purpose: Balloon pulmonary angioplasty (BPA) is an emerging treatment for inoperable chronic thromboembolic pulmonary hypertension (CTEPH) patients. However, the approach to use to identify distal thrombi suitable for BPA has not yet been established. The purpose of this work was therefore to evaluate distal chronic thromboembolic lesions for BPA using cone-beam computed tomography (CBCT). Materials and methods: Thirty-two patients (men/women: 9/23) with CTEPH who underwent CBCT before BPA were enrolled. We assessed representative forms of chronic thromboembolic lesions in 94 segmental and/or 208 subsegmental branches according to CBCT and compared the results to the findings of selective angiography during BPA. Results: We classified CTEPH lesions into five subtypes as follows: type 1a (11.1 %), webs; type 1b (14.4 %), web with severe narrowing of the subsegmental artery; type 2, (58.2 %) web and slits; type 3 (2.4 %), slits; and type 4 (13.9 %), pouch defect with incomplete obstruction of subsegmental branches or complete occlusion. In our study, 92.6 % of the CTEPH lesions diagnosed by CBCT were highly consistent with the findings of selective angiography during BPA. Conclusion: CBCT clearly revealed and classified distal lesions in CTEPH patients. The CBCT findings for distal lesions were highly consistent with those of selective angiography during BPA. CBCT could be a useful modality to detect target lesions before BPA.

Original languageEnglish
Pages (from-to)423-431
Number of pages9
JournalJapanese Journal of Radiology
Volume34
Issue number6
DOIs
Publication statusPublished - 2016 Jun 1
Externally publishedYes

Keywords

  • Balloon pulmonary angioplasty (BPA)
  • Chronic thromboembolic pulmonary hypertension (CTEPH)
  • Cone beam CT (CBCT)
  • Pulmonary endarterectomy (PEA)

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Fingerprint Dive into the research topics of 'Evaluation of organized thrombus in distal pulmonary arteries in patients with chronic thromboembolic pulmonary hypertension using cone-beam computed tomography'. Together they form a unique fingerprint.

Cite this