Recurrent pulmonary thrombosis after balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension
Recurrent pulmonary thrombosis after balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension
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慢性血栓栓塞性肺动脉高压球囊肺动脉成形术后复发性肺血栓
DOI：
10.1093/eurheartj/ehac419
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发表时间：
2022
影响因子：
39.3
通讯作者：
Keiichi Fukuda
中科院分区：
文献类型：
--
作者：
Tomohiko C Umei;Yoshikazu Kishino;Takashi Kawakami;Keiichi Fukuda
一名有慢性血栓栓塞性肺动脉高压病史的 65 岁男性接受了球囊肺血管成形术 (BPA) 联合利伐沙班 15 mg，每日一次。使用 81mKrypton 和 99mTechnetium 的肺通气/灌注闪烁扫描显示多个节段和亚节段不匹配的灌注缺陷（图 A 和 B），诊断时的肺动脉血管造影（PAG）显示不规则的血管轮廓和闭塞，位于节段和亚节段肺动脉（图 C 和 D，请参阅在线补充材料，视频 S1 和S2）。经过多次干预后，节段性PAG显示血流改善，平均肺动脉压（PAP）随着症状的改善从31毫米汞柱改善至25毫米汞柱。但出院后患者感到劳力性呼吸困难逐渐加重，BPA后3个月PAG显示左A10肺动脉分支充盈缺损
A 65-year-old man with history of chronic thromboembolic pulmonary hypertension underwent balloon pulmonary angioplasty (BPA) combined with rivaroxaban 15 mg once daily. Lung ventilation/perfusion scintigraphy using 81mKrypton and 99mTechnetium showed multiple segmental and sub-segmental mismatched perfusion defects (Panels A and B), and pulmonary artery angiography (PAG) at the time of diagnosis showed irregular vessel contour and occlusion which localized in segmental and sub-segmental pulmonary artery (Panels C and D, see Supplementar y material online, Videos S1 and S2). After several times of interventions, segmental PAG showed improved flows, and the mean pulmonary artery pressure (PAP) was improved from 31 to 25 mmHg along with his symptoms improvement. However, the patient felt gradually worsening dyspnoea on exertion after discharge, and PAG 3 months after BPA showed the filling defect in left A10 pulmonary artery branches