title: Angioscopic observation in chronic thromboembolic pulmonary hypertension before and after balloon pulmonary angioplasty.
abstract: : We here report the angioscopic assessment of inoperable peripheral chronic thromboembolic pulmonary hypertension in an 81-year-old man who was previously diagnosed with the disease. To assess the pathological morphology of the web lesion, pouch defect and band lesion, we used two types of angioscopic catheter: blood flow-maintaining type and blood flow-blocking type. Angioscopy revealed a heterogeneous thrombus that contained white organized thrombus, red fragile thrombus and yellowish thrombus. After three sessions of balloon pulmonary angioplasty, his pulmonary arterial pressure decreased and his symptom of dyspnea on exertion and desaturation were improved. Angioscopy displayed various forms of organized thrombus, and also allowed the detailed observation of lesions that were difficult to be observed by angiography.
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Naohiko
authors.initials: N
authors.lastname: Nakanishi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakamura
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Yamano
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Shiraishi
authors.forename: Satoaki
authors.initials: S
authors.lastname: Matoba
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Matsumuro
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shirayama
mesh_terms: D000369:Aged, 80 and over; D000792:Angiography; D000800:Angioplasty, Balloon; D017546:Angioscopy / Q000295:instrumentation; D062186:Arterial Pressure; D002908:Chronic Disease; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D011237:Predictive Value of Tests; D011651:Pulmonary Artery / Q000473:pathology* / Q000503:physiopathology; D011655:Pulmonary Embolism / Q000150:complications / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D062666:Vascular Access Devices