Keywords:
Embolism / Thrombosis, Treatment effects, Surgery, Angioplasty, CT-Angiography, Lung, Cardiovascular system
Authors:
A. Demchenkova, T. N. Veselova, T. Martynyuk, N. Danilov, K. Mershin, S. K. Ternovoy, I. E. Chazova; Moscow/RU
Results
In all patients were detected pulmonary perfusion abnormalities.
Thrombotic masses in pulmonary arteries were identified in 42 patients.
In 3 patients was detected intraluminal bands and webs in segmental arteries by CTPA,
which didn't detect by digital subtraction angiography (DSA).
The mean values of CTA obstruction score and perfusion defect score were 38,1 ± 21,3% and 53,7 ± 21,1%,
respectively.
The mean value of mean pulmonary arterial pressure (mPAP) was 47,9±12,8.
The significant correlation was found between CTA obstruction score and perfusion defect score (r =0,3,
p=0,02).
mPAP correlated with MPA diameter (r = 0,4,
p = 0,01),
RV wall thickness (r = 0,6,
p = 0,0003) and the ratio of MPA diameter to ascending aortic diameter (r = 0,5,
p = 0,002).
The significant correlation was found between RV wall thickness and pulmonary vascular resistance (PVR) (r = 0,4,
p = 0,04).
In cardiovascular parameters,
neither CTA obstruction score nor perfusion defect score did correlate with PVR.
Concordance between CTPA and DSA was 83,9 % regarding the localization of filling defects and degree of obstruction of the vascular bed.
According to post-treatment CTPA a significant improvement of the blood flow of the distal vascular bed was detected in all patients after balloon angioplasty of pulmonary arteries and pulmonary thromboendarterectomy.
However,
the perfusion of lungs improved only in 3 patients after balloon angioplasty of pulmonary arteries and 2 patients after pulmonary thromboendarterectomy.