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Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet
Published on: November 4, 2015
Pathology of pulmonary thromboembolism
1Department of Pathology, Erasmus University, Amsterdam, The Netherlands.
Chest
|January 1, 1995
Summary
Assessing pulmonary thromboembolism is challenging due to variations in autopsy scrutiny and microscopic search areas. Differentiating primary thrombi from emboli remains difficult, impacting pulmonary hypertension diagnosis.
Area of Science:
- Pathology
- Cardiovascular Medicine
- Pulmonary Medicine
Background:
- Pulmonary thromboembolism (PTE) incidence is difficult to ascertain due to seasonal variations and thrombolysis.
- Discrepancies in autopsy estimates stem from inconsistent investigation scrutiny and microscopic search areas.
- Major pulmonary artery obstruction is typically acute thromboembolism, while chronic forms can cause pulmonary hypertension.
Purpose of the Study:
- To explore the challenges in assessing pulmonary thromboembolism incidence.
- To differentiate between primary thrombi and emboli in pulmonary arteries.
- To characterize thrombotic arteriopathy and its association with pulmonary hypertension.
Main Methods:
- Review of autopsy findings and pathological criteria for pulmonary embolism.
- Microscopic examination of pulmonary arteries to identify thrombi and emboli.
- Analysis of histological features of thrombotic arteriopathy.
Main Results:
- No reliable criteria exist to distinguish emboli from primary thrombi or their sequelae.
- Peripheral pulmonary artery thrombi are often primary, especially with advanced age and pulmonary hypertension.
- Thrombotic arteriopathy, linked to thrombosis or embolism, features intimal fibrosis and recanalization, often irreversible.
Conclusions:
- Accurate assessment of pulmonary thromboembolism incidence is hindered by methodological variations.
- Distinguishing between primary thrombi and emboli is crucial for understanding pulmonary arterial disease.
- Thrombotic arteriopathy, a consequence of thrombosis or embolism, frequently leads to irreversible pulmonary hypertension.
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