Peripheral interventions

A multistage strategy of perfusion SPECT and CT pulmonary angiogram in balloon pulmonary angioplasty for totally occluded lesions

EuroIntervention 2021;17:e167-e168. DOI: 10.4244/EIJ-D-20-00652

Kazuya Hosokawa
Kazuya Hosokawa1, MD, PhD; Kohtaro Abe1, MD, PhD; Yuzo Yamasaki2, MD, PhD; Hiroyuki Tsutsui1, MD, PhD
1. Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan; 2. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Figure 1. Multistaged BPA strategy with multimodalities for a total occlusion. A) Three-dimensional perfusion SPECT/CTPA fusion image. B) Volume-rendered image of CTPA. C) CTPA-MIP image. D) MIP-guided BPA.

A 56-year-old man with chronic thromboembolic pulmonary hypertension (CTEPH) was admitted to our hospital. Balloon pulmonary angioplasty (BPA) performed twice decreased the mean pulmonary artery pressure (PAP) from 37 to 20 mmHg and pulmonary vascular resistance (PVR) from 3.2 to 2.7 Wood units. However, he showed persistent exercise intolerance (World Health Organization [WHO] functional class III). We performed perfusion single photon emission computed tomography (SPECT) and CT pulmonary angiography (CTPA) and found some residual ...

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