CTICasesRecurrent Chronic Thromboembolic Pulmonary Hypertension (CTEPH)
Imaging findings
A contrast-enhanced chest CT scan obtained two years after a bilateral pulmonary endarterectomy demonstrates abrupt cutoff, contraction, and complete occlusion of the basal segment pulmonary arteries of the lower lobes, with preservation of the superior segment perfusion. The companion VQ scan confirms new perfusion defects in the lower lobes.
Key takeaways
Even after successful pulmonary endarterectomy (PEA) for chronic thromboembolic pulmonary hypertension (CTEPH), patients remain at risk for recurrent in-situ thrombosis or thromboembolism. Long-term surveillance with VQ scanning and chest CT is crucial for detecting late recurrence of vascular occlusion and worsening pulmonary hypertension.
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