AUTHOR=Tang Yinjiang , Xu Ou , Zhang Chunmei , Bao Xia , Ye Shaodong 

TITLE=Case Report: Zero-contrast balloon pulmonary angioplasty guided by real-time fusion of CT angiography with x-ray fluoroscopy

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1435795

DOI=10.3389/fcvm.2024.1435795

ISSN=2297-055X

ABSTRACT=BackgroundAllergy to iodine contrast agents has long been a contraindication for balloon pulmonary angioplasty (BPA). We report the successful zero-contrast BPA procedure of a patient with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) and severe iodine allergy using real-time fusion of computed tomography angiography (CTA) with x-ray fluoroscopy.Case presentationA 62-year-old woman with CTEPH who developed a severe allergic reaction after the first BPA procedure. The second BPA procedure was successfully performed using the fusion of previous pulmonary artery CTA images and real-time fluoroscopy images. Pulmonary artery pressure showed a significant decrease after performing BPA twice. As of 6-month follow-up, the patient has recovered well.Conclusion3 Dimensions (3D) reconstruction of CTA images and real-time fluoroscopic image fusion navigation technology provide a new option for BPA treatment in patients allergic to iodine contrast agents.