title: Predictors of patient response to pulmonary thromboendarterectomy.
abstract: OBJECTIVE
  We sought to identify imaging features that help predict surgical success in patients undergoing thromboendarterectomy.
  
  
  METHODS
  Thirty-nine consecutive patients who underwent pulmonary angiography and thromboendarterectomy during 1995 and 1996 were included. Thirty-four underwent helical CT angiography. Measurements of postoperative pulmonary vascular resistance were compared with preoperative imaging features and preoperative pulmonary vascular resistance.
  
  
  RESULTS
  The best imaging indicators of a relatively high postoperative pulmonary vascular resistance were the extent of small vessel disease identified on CT angiograms as segments with abnormal perfusion but normal segmental arteries (p = 0.005) and the extent of central disease (p = 0.015). Combined with preoperative pulmonary vascular resistance, these features had a strong correlation with postoperative outcome (p = 0.0005). Segmental arterial disease seen on both conventional angiography and CT angiography correlated poorly with surgical outcome.
  
  
  CONCLUSIONS
  In patients with chronic thromboembolic pulmonary hypertension, CT angiographic evidence of extensive central vessel disease and limited small vessel involvement indicates a favorable surgical outcome.
authors.affiliation: Department of Radiology, University of California, San Diego 92103, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: Bergin
authors.forename: C
authors.initials: C
authors.lastname: Sirlin
authors.forename: R
authors.initials: R
authors.lastname: Deutsch
authors.forename: P
authors.initials: P
authors.lastname: Fedullo
authors.forename: J
authors.initials: J
authors.lastname: Hauschildt
authors.forename: T
authors.initials: T
authors.lastname: Huynh
authors.forename: W
authors.initials: W
authors.lastname: Auger
authors.forename: M
authors.initials: M
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004691:Endarterectomy; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014655:Vascular Resistance