Pulmonary microvascular remodeling after balloon pulmonary angioplasty in a patient with chronic thromboembolic pulmonary hypertension.

We herein report a case of peripheral type chronic thromboembolic pulmonary hypertension treated with medical therapy and subsequent balloon pulmonary angioplasty (BPA). After a series of BPA procedures, the patient's hemodynamics almost completely normalized. The patient was later diagnosed with lung carcinoma, and the vasculature of the resected lung demonstrated intimal thickening and luminal stenosis in the pulmonary arteries in both the areas where BPA was performed and not performed, in spite of a marked reduction in pulmonary arterial pressure. The present case is the first report on the histology of the pulmonary vasculature following BPA.