Back to the list
Congress: ECR26
Poster Number: C-26097
Type: Poster: EPOS Radiologist (educational)
Authorblock: M. X. Schenato, D. Koltermann Da Silva, B. L. Bernardi, K. C. B. Zinn, C. E. Nedel, J. Gonçalves Silveira, A. P. Zanardo, J. Fávero Prietto dos Santos, R. D. Grando; Porto Alegre/BR
Disclosures:
Mateus Xavier Schenato: Nothing to disclose
Débora Koltermann Da Silva: Nothing to disclose
Bárbara Luiza Bernardi: Nothing to disclose
Karina Correa Brum Zinn: Nothing to disclose
Carlos Eduardo Nedel: Nothing to disclose
Juliana Gonçalves Silveira: Nothing to disclose
Ana Paula Zanardo: Nothing to disclose
Jônatas Fávero Prietto dos Santos: Nothing to disclose
Rafael Domingos Grando: Nothing to disclose
Keywords: Thorax, CT, CT-Angiography, Plain radiographic studies, Ablation procedures, Outcomes
Learning objectives Catheter ablation has become an established therapeutic option for atrial fibrillation, with continuously improving efficacy and safety profiles. Advances in mapping systems, energy delivery, and ablation strategies have contributed to a reduction in procedure-related complications. Nevertheless, pulmonary vein stenosis remains a recognised adverse outcome, particularly associated with thermal injury at or near the pulmonary vein ostia. Although its incidence has decreased with the widespread adoption of wide antral and circumferential ablation techniques, clinically relevant cases continue to be encountered in...
Read more Background Pulmonary vein stenosis following catheter ablation for atrial fibrillation is an acquired condition resulting from endothelial and transmural injury induced by energy delivery at the pulmonary vein–left atrial junction or within the venous lumen. The ensuing reparative process may involve intimal hyperplasia, fibrosis, and progressive contraction of the vessel wall, ultimately leading to partial or complete luminal obstruction. The clinical impact of this process depends on the degree of stenosis, the number of veins involved, and the capacity for collateral...
Read more Findings and procedure details In all four cases, pulmonary vein stenosis was identified several months after atrial fibrillation ablation, in keeping with the delayed nature of post-procedural venous remodelling described in the literature. The left-sided pulmonary veins were predominantly affected, most commonly the left superior pulmonary vein, consistent with previously reported anatomical and procedural susceptibility. The severity of involvement ranged from high-grade focal stenosis to complete venous occlusion. Direct imaging findings included marked narrowing of the pulmonary vein lumen, abrupt termination of contrast opacification, and...
Read more Conclusion Pulmonary vein stenosis remains a clinically relevant complication of catheter ablation for atrial fibrillation, despite substantial reductions in incidence achieved through contemporary ablation techniques. Its diagnosis is often challenging due to delayed onset, variable symptomatology, and imaging findings that may mimic more common pulmonary conditions. This case series illustrates the spectrum of direct and indirect imaging features associated with pulmonary vein stenosis and underscores the central role of contrast-enhanced computed tomography in its detection and characterisation. Multiplanar, maximum intensity projection, and...
Read more Personal information Department of Radiology, Hospital Moinhos de Vento910 Ramiro Barcelos, Porto Alegre, Brazil.M. X. Schenato: nothing to discloseD. Koltermann Da Silva: nothing to discloseB. L. Bernardi: nothing to discloseK. C. B. Zinn: nothing to discloseC. E. Nedel: nothing to discloseJ. G. Silveira: nothing to discloseA. P. Zanardo: nothing to discloseJ. F. P. dos Santos: nothing to discloseR. D. Grando: nothing to discloseEmail for contact: [email protected]
Read more References 1. Simard T, Hibbert B, Ramirez FD, et al. Pulmonary vein stenosis: pathogenesis, evaluation, and management. Canadian Journal of Cardiology. 2023;39(3):294–306.2. Schoene K, Arya A, Jahnke C, et al. Acquired pulmonary vein stenosis after radiofrequency ablation for atrial fibrillation: single-center experience in catheter interventional treatment. JACC: Cardiovascular Interventions. 2018;11(16):1626–1632.3. Barrett CD, Di Biase L, Natale A. Pulmonary vein stenosis: diagnosis and management. Circulation. 2009;119(21):e489–e491.4. Galizia M, Renapurkar R, Prieto L, Bolen M, Azok J, Lau CT, El-Sherief AH. Radiologic review of...
Read more
GALLERY