Chronic thromboembolic pulmonary hypertension: Evaluation with 64-detector row CT versus digital substraction angiography

Reichelt, A.; Hoeper, Marius M.; Galanski, Michael; Keberle, Marc

doi:10.1016/j.ejrad.2008.03.016

Cited by 130 publications

(63 citation statements)

References 24 publications

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“…It can delineate the typical angiographic findings in CTEPH, such as complete obstruction, bands and webs and intimal irregularities, as accurately and reliably as digital subtraction angiography [54,55]. With this technique, collaterals from bronchial arteries can be identified.…”

Section: Echocardiographymentioning

confidence: 99%

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

et al. 2015

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Guidelines summarize and evaluate all available evidence on a particular issue at the time of the writing process, with the aim of assisting health professionals in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic or therapeutic means. Guidelines and recommendations should help health professionals to make decisions in their daily practice. However, the final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver as appropriate.

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Section: Echocardiographymentioning

confidence: 99%

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

et al. 2015

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“…They reported that the sensitivity and specificity of CT for detecting general CTEPHrelated pathological changes were 98.3% and 94.8% at the main/lobar level and 94.1% and 92.9% at the segmental level, respectively. The sensitivity and specificity of CT regarding the different pathological criteria of CTEPH (complete obstruction, intimal irregularities, bands and webs and indirect signs) were 88.9% to 100.0% and 96.1% to 100.0% at the main/lobar level and 84.3% to 90.5% and 92.0% to 98.7% at the segmental level respectively, Reichelt et al reported that CT is an accurate and reliable noninvasive alternative to conventional digital subtraction angiography in the diagnostic workup of patients with CTEPH [11]. The extent of central disease (CD) could be scored (i.e., the CD score) and a CD score of ≤ 1 was judged as relatively peripheral disease [12].…”

Section: Discussionmentioning

confidence: 99%

Ratio of Pulmonary Vascular Resistance to Occluded Pulmonary Segments as an Indicator of Operability of Chronic Thromboembolic Pulmonary Hypertension Lesions

Huili¹,

Zhang²,

Ling³

2017

J Hematol Thrombo Dis

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Objective: The operability evaluation for pulmonary thromboendarterectomy (PEA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) is always difficult. In this study, we aimed to identify a better indicator of operability in patients with surgically accessible CTEPH lesions.Methods: Two-hundred-eight patients with surgically accessible CTEPH lesions who underwent PEA at Beijing Anzhen Hospital from March 2001 to February 2014 were retrospectively reviewed. The occluded pulmonary segments (OPS) were assessed by ventilation/perfusion scintigraphy, pulmonary vascular resistance (PVR) was measured by right heart catheterization and the PVR/OPS ratio was calculated.Results: Seven (3.37%) early deaths occurred in the post-PEA period, six late deaths occurred during the mean follow-up period of 58.3 ± 39.7 months; the 5 year actuarial survival rate was 95.1% ± 3.5%. The PVR/OPS ratios of early and late death after PEA were significantly higher than those of early and late survival, respectively. A PVR/OPS ratio of <100 dyne·s·cm-5/OPS had much better specificity (88.7% vs. 69.2%) and sensitivity (92.3% vs. 38.5%) than did PVR alone in the prediction of early and late survival. The difference between the two areas under their receiver operating characteristic curves reached statistical significance (z test: Z=1.9917, P=0.046). Conclusion:The PVR/OPS ratio is a better indicator of operability for surgically accessible CTEPH than is PVR alone. Patients with a PVR/OPS ratio of <100 dyne·s·cm-5/OPS have better early and long-term outcomes after PEA.

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“…Bilgisayarlı tomografide ana, lobar ve segmental pulmoner arterlerde total obstrüksiyon, bantlar ve ağ görünümü ve intimal düzensizlik gibi KTEPH için tipik olan anjiyografik bulguların çok kaliteli görüntülerini elde etmek mümkün olur (28). KTEPH'da görülebilen diğer bulgular arasında akciğer parankiminde mozaik perfüzyon, santral pulmoner arterlerde genişleme, sağ boşluklarda genişleme, periferik skar benzeri dansiteler, sistemik arteriyel sistemden kaynaklanan mediastinal kollateral damarlar sayılabilir (29).…”

Section: Tanıunclassified

Chronic thromboembolic pulmonary hypertension: diagnosis, medical therapy and monitoring

Gölbaşı¹

2010

Anadolu Kardiyol Derg

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Chronic thromboembolic pulmonary hypertension (CTEPH) is caused by obstruction of the large pulmonary arteries by acute and recurrent pulmonary emboli with subsequent organization of these blood clots. Because of a lack of clinically evident acute-pulmonary embolism episodes in >50% of patients, the diagnosis of CTEPH can be difficult. Lung ventilation/perfusion scintigraphy showing segmentary mismatched perfusion defects is the best diagnostic tool to detect CTEPH. Although pulmonary endarterectomy is considered the treatment of choice for patients with CTEPH, it can not be performed in a substantial proportion of patients. Medical therapies have been increasingly used in subcategories of CTEPH patients. (Anadolu Kardiyol Derg 2010; 10: Suppl 2; 56-60) Key words: Pulmonary embolism, pulmonary hypertension, chronic thromboembolic pulmonary hypertension ÖZETKronik tromboembolik pulmoner hipertansiyon (KTEPH), akut ve yineleyen pulmoner emboliler ve bunların organize olması sonucu büyük pulmoner arterlerin obstrüksiyonu ile oluşur. Hastaların %50'den fazlasında klinik olarak belirti veren akut pulmoner emboli atağının bulunmayışı sebebiyle KTEPH tanısı zor olabilir. KTEPH'nun tespitinde ventilasyonla uyumsuz segmental perfüzyon defekti bulunan akciğer ventilasyon/perfüzyon sintigrafisi en iyi tanı aracıdır. KTEPH'lu hastaların tedavisinde pulmoner endarterektomi (PEA) en iyi tedavi seçeneği olarak görülmekle birlikte, hastaların önemli bir bölümünde yapılamayabilir. KTEPH'lu hastaların bazı alt gruplarında tıbbi tedavi giderek daha artan oranda kullanılmaktadır.

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Chronic thromboembolic pulmonary hypertension: Evaluation with 64-detector row CT versus digital substraction angiography

Cited by 130 publications

References 24 publications

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

Ratio of Pulmonary Vascular Resistance to Occluded Pulmonary Segments as an Indicator of Operability of Chronic Thromboembolic Pulmonary Hypertension Lesions

Chronic thromboembolic pulmonary hypertension: diagnosis, medical therapy and monitoring

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