Selective Segmental Pulmonary Angiography: Anatomical, Technical and Safety Aspects of a Must-Learn Technique in Times of Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension
With the advent of balloon pulmonary angioplasty (BPA) for non-surgical chronic thromboembolic pulmonary hypertension (CTEPH) patients, there is renewed interest in the pulmonary angiography technique. This technique is still the standard imaging modality to confirm CTEPH, which, in addition, helps...
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doaj-1962c5ffa0e74fc4b721d6844e7be9712021-08-06T15:26:55ZengMDPI AGJournal of Clinical Medicine2077-03832021-07-01103358335810.3390/jcm10153358Selective Segmental Pulmonary Angiography: Anatomical, Technical and Safety Aspects of a Must-Learn Technique in Times of Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary HypertensionMaite Velázquez0Nicolás Maneiro1Ana Lareo2Agustín Albarrán3Sergio Huertas4Allende P. Olazábal5Juan F. Delgado6Sergio Alonso7Fernando Sarnago8Julio García Tejada9Fernando Arribas10Pilar Escribano11Cardiology Department, University Hospital 12 de Octubre, 28041 Madrid, SpainCardiology Department, University Hospital 12 de Octubre, 28041 Madrid, SpainCardiology Department, University Hospital 12 de Octubre, 28041 Madrid, SpainCardiology Department, University Hospital 12 de Octubre, 28041 Madrid, SpainCardiology Department, University Hospital 12 de Octubre, 28041 Madrid, SpainCardiology Department, University Hospital 12 de Octubre, 28041 Madrid, SpainCardiology Department, University Hospital 12 de Octubre, 28041 Madrid, SpainInstituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, SpainCardiology Department, University Hospital 12 de Octubre, 28041 Madrid, SpainCardiology Department, University Hospital 12 de Octubre, 28041 Madrid, SpainCardiology Department, University Hospital 12 de Octubre, 28041 Madrid, SpainCardiology Department, University Hospital 12 de Octubre, 28041 Madrid, SpainWith the advent of balloon pulmonary angioplasty (BPA) for non-surgical chronic thromboembolic pulmonary hypertension (CTEPH) patients, there is renewed interest in the pulmonary angiography technique. This technique is still the standard imaging modality to confirm CTEPH, which, in addition, helps to determine the most appropriate treatment. Furthermore, learning this technique fulfills two main purposes: to identify BPA candidates and to provide the operator with the catheter handling needed to perform BPA. Operators interested in performing BPA must learn not only the pulmonary arteries’ anatomy, but also which are the best angiographic projections and the most suitable catheters to canalize and display each segmental branch. Unfortunately, this information is scarce in the literature. With this goal, learning the diagnostic pulmonary angiography technique can be a first step on the way to perform BPA. Although there are descriptions on how to perform a pulmonary angiography with balloon-tipped catheters and the digital subtraction technique, this technique does not provide operators with the catheter knowledge and manual skill needed to cannulate each segmental branch. In contrast, learning the conventional selective segmental pulmonary angiography (SSPA) technique provides the operator with this knowledge and skills. In this review, based on the experience of the authors, we describe the pulmonary arteries’ anatomy and detail the practical aspects of the SSPA procedure, with the aim of providing operators with the anatomical and technical knowledge needed to perform BPA. We also summarize the contemporary complications of SSPA in CTEPH patients at a reference center.https://www.mdpi.com/2077-0383/10/15/3358selective pulmonary angiographychronic thromboembolic pulmonary hypertensionballoon pulmonary angioplastypulmonary arteries’ anatomy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Maite Velázquez Nicolás Maneiro Ana Lareo Agustín Albarrán Sergio Huertas Allende P. Olazábal Juan F. Delgado Sergio Alonso Fernando Sarnago Julio García Tejada Fernando Arribas Pilar Escribano |
spellingShingle |
Maite Velázquez Nicolás Maneiro Ana Lareo Agustín Albarrán Sergio Huertas Allende P. Olazábal Juan F. Delgado Sergio Alonso Fernando Sarnago Julio García Tejada Fernando Arribas Pilar Escribano Selective Segmental Pulmonary Angiography: Anatomical, Technical and Safety Aspects of a Must-Learn Technique in Times of Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension Journal of Clinical Medicine selective pulmonary angiography chronic thromboembolic pulmonary hypertension balloon pulmonary angioplasty pulmonary arteries’ anatomy |
author_facet |
Maite Velázquez Nicolás Maneiro Ana Lareo Agustín Albarrán Sergio Huertas Allende P. Olazábal Juan F. Delgado Sergio Alonso Fernando Sarnago Julio García Tejada Fernando Arribas Pilar Escribano |
author_sort |
Maite Velázquez |
title |
Selective Segmental Pulmonary Angiography: Anatomical, Technical and Safety Aspects of a Must-Learn Technique in Times of Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension |
title_short |
Selective Segmental Pulmonary Angiography: Anatomical, Technical and Safety Aspects of a Must-Learn Technique in Times of Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension |
title_full |
Selective Segmental Pulmonary Angiography: Anatomical, Technical and Safety Aspects of a Must-Learn Technique in Times of Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension |
title_fullStr |
Selective Segmental Pulmonary Angiography: Anatomical, Technical and Safety Aspects of a Must-Learn Technique in Times of Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension |
title_full_unstemmed |
Selective Segmental Pulmonary Angiography: Anatomical, Technical and Safety Aspects of a Must-Learn Technique in Times of Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension |
title_sort |
selective segmental pulmonary angiography: anatomical, technical and safety aspects of a must-learn technique in times of balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-07-01 |
description |
With the advent of balloon pulmonary angioplasty (BPA) for non-surgical chronic thromboembolic pulmonary hypertension (CTEPH) patients, there is renewed interest in the pulmonary angiography technique. This technique is still the standard imaging modality to confirm CTEPH, which, in addition, helps to determine the most appropriate treatment. Furthermore, learning this technique fulfills two main purposes: to identify BPA candidates and to provide the operator with the catheter handling needed to perform BPA. Operators interested in performing BPA must learn not only the pulmonary arteries’ anatomy, but also which are the best angiographic projections and the most suitable catheters to canalize and display each segmental branch. Unfortunately, this information is scarce in the literature. With this goal, learning the diagnostic pulmonary angiography technique can be a first step on the way to perform BPA. Although there are descriptions on how to perform a pulmonary angiography with balloon-tipped catheters and the digital subtraction technique, this technique does not provide operators with the catheter knowledge and manual skill needed to cannulate each segmental branch. In contrast, learning the conventional selective segmental pulmonary angiography (SSPA) technique provides the operator with this knowledge and skills. In this review, based on the experience of the authors, we describe the pulmonary arteries’ anatomy and detail the practical aspects of the SSPA procedure, with the aim of providing operators with the anatomical and technical knowledge needed to perform BPA. We also summarize the contemporary complications of SSPA in CTEPH patients at a reference center. |
topic |
selective pulmonary angiography chronic thromboembolic pulmonary hypertension balloon pulmonary angioplasty pulmonary arteries’ anatomy |
url |
https://www.mdpi.com/2077-0383/10/15/3358 |
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