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CARDIOVASCULAR FLASHLIGHT
doi:10.1093/eurheartj/ehv736
Online publish-ahead-of-print 21 January 2016
.............................................................................................................................................................................
Optical frequency-domain imaging and pulmonary angioscopy in chronic
thromboembolic pulmonary hypertension
Hidetoshi Chibana, Nobuhiro Tahara, Naoki Itaya, Masahiro Sasaki, Motoki Sasaki, Takaharu Nakayoshi,
Masanori Ohtsuka, Shinji Yokoyama, Ken-ichiro Sasaki, Takafumi Ueno, and Yoshihiro Fukumoto*
Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, Kurume 830-0011, Japan
* Corresponding author. Tel: +81-942-31-7562, Fax: +81-942-33-6509, Email: [email protected]
Unresolved thromboemboli in the pulmonary arteries (PAs) cause chronic thromboembolic pulmonary hypertension (CTEPH), which is usually diagnosed by mismatched perfusion defects on ventilation-perfusion lung
scintigraphy and chronic thromboembolic signs on computed tomography (CT) scan and/or conventional pulmonary angiography. In our recent three cases of CTEPH (Case 1; a 75-year-old woman, mean PA
pressure (PAP) 45 mmHg, PA wedge pressure (PAWP) 9 mmHg, Case
2; a 84-year-old woman, mean PAP 33 mmHg, PAWP 6 mmHg, Case 3;
a 66-year-old woman, mean PAP 36 mmHg, PAWP 9 mmHg, evaluated
by right heart catheterization), we were able to observe the unresolved
PA thromboemboli, such as thrombus and mesh-like lesions (Panel,
Supplementary material online, Video), in both optical frequency-domain
imaging and pulmonary angioscopy. These techniques are useful especially
to diagnose distal-type CTEPH or to detect thin chronic thrombus, which
has some difficulties in CT scan and/or pulmonary angiography. Further, if
3D printed model of PA lesions by OFDI or angioscopy is developed in
each patient in near future, it might be a great help for pulmonary endarterectomy or balloon pulmonary angioplasty.
Panel Optical frequency-domain imaging and pulmonary angioscopy
showed thrombus (Panels A and B; Case 1) and mesh-like lesions (Panels
C and D; Case 1, Panels E and F; Case 2, Panels G and H; Case 3) of the
pulmonary arteries in patients with CTEPH.
Supplementary material is available at European Heart Journal online.
Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2016. For permissions please email: [email protected].