Pulmonary artery-pulmonary artery collaterals in chronic thromboembolic pulmonary hypertension
A 66-year-old woman was diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH), with selective angiography revealing direct collaterals between the A9 and A10 pulmonary artery branches (figure 1A, figure 2 and figure 3A; online supplemental Video 1 and online supplemental Video 2). Balloon pulmonary angioplasty (BPA) of A9 revealed pronounced stenosis and lumen irregularities. Peripheral branches of A9, adjacent to A10, demonstrated compromised perfusion, as indicated in figure 1B. The subsequent BPA intervention on the A9 main branch involved a 3 mm balloon inflated to a pressure of 12 mm Hg for a duration of 5 s, repeated twice (figure 1C). Post-intervention angiography painted an optimistic picture: enhanced perfusion of the A9 branch and the …