Spiral CT of Bronchial Arteries in Chronic Thromboembolism

Dilatation of Bronchial Arteries Correlates With Extent of Central Disease in Patients With Chronic Thromboembolic Pulmonary Hypertension

“…The total area of the BAs in the CTEPH patients was significantly larger than that in the PAH patients. In the CTEPH group, as in earlier studies, 8,9 we did not find any significant correlation between the total area of the BAs and the preoperative mean pulmonary artery pressure or the PVR, meaning that the severity of pulmonary hypertension was not a stimulus for the development of dilated BAs.…”

“…[10][11][12][13] Moreover, CT angiography is also being recognized as a useful test for evaluating the development of systemic collateral supply to the lung. [2][3][4]8,9,14 Remy-Jardin et al showed that multidetector row helical CT angiography depicts the BAs more precisely than conventional angiography. 14 Therefore, in the present study we also used multidetector row helical CT angiography to evaluate the dilatation of the BAs.…”

“…8,9 Those studies classified patients into 2 groups, with (≥1.5 mm) or without (<1.5 mm) dilated BAs. Ley et al showed a correlation between the cross-sectional area of BAs assessed by CT angiography and the bronchopulmonary shunt volume assessed by magnetic resonance imaging.…”

Chronic Thromboembolic Pulmonary Hypertension: Pearls and Pitfalls of Diagnosis

“…22,26,27 Additionally, enlarged bronchial arteries and collateral arteries from systemic circulation may also be seen on the CTPA of a patient with CTEPH and can further help to risk stratify patients undergoing PEA surgery. 25,26,[28][29][30][31][32][33][34][35] In a case series comparing CTPA to pulmonary angiography (the gold standard for diagnosing chronic thromboemboli), it was found that both imaging modalities were equally effective in the determination of disease amenable to resection. 26 Despite such findings, evaluation of patients for CTEPH still entails undergoing a pulmonary angiography.…”

Die Ballon-Okklusionsangiographie der Pulmonalarterien bei chronischer pulmonaler Hypertonie

“…Die bronchiale Zirkulation weitet sich aus, hypertrophiert, proliferiert entlang der Anastomosen und steigert den Blutfluss um bis zu 300% (Kauczor et al, 1994). Insbesondere im Falle einer zentralen Gefäßobstrukton, zum Beispiel durch eine Thrombembolie proximal der bronchopulmonalen Anastomosen, kommt es zu einem Kollateralfluss aus der systemischen Zirkulation in das pulmonalarterielle Gefäßbett distal des Verschlusses, wodurch die ischämische Nekrose des Lungenparenchymes in den meisten Fällen ausbleibt.…”