CTICasesCTEPH with Pulmonary Artery-to-Pulmonary Artery Collaterals
Imaging findings
Chest CT and conventional pulmonary angiography demonstrate a complete occlusion of the left lower lobe pulmonary artery with subsequent distal reconstitution via a network of tortuous, corkscrew-like collateral vessels originating from the patent posterior segmental pulmonary artery. Additional features of chronic thromboembolic pulmonary hypertension are visible throughout the lungs.
Key takeaways
Pulmonary artery-to-pulmonary artery collaterals are an exceptionally rare finding in chronic thromboembolic pulmonary hypertension (CTEPH). These systemic-mimicking vascular pathways typically develop early in life following a thromboembolic event during childhood, allowing flow from patent arterial branches to reconstitute flow in distal, occluded segmental vessels.
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