Peripheral pulmonary wedge angiography in chronic obstructive pulmonary disease. Relationship to pulmonary function, chest x-ray film, and hemodynamic data.

Peripheral pulmonary wedge angiographic studies can investigate only limited areas of the pulmonary vascular bed; nevertheless, this technique is very useful in emphasizing the morphologic changes of small vessels (less than 1 mm in diameter) in pulmonary emphysema. The aim of this work is to determine the relationship between peripheral wedge angiographic appearances and pulmonary function, the chest x-ray film, and hemodynamic data in patients with chronic obstructive pulmonary disease. Three healthy subjects, four patients with type-A chronic obstructive pulmonary disease, and eight patients with type-B chronic obstructive pulmonary disease were studied. Among the tests of pulmonary function, only a marked reduction (less than 60 percent of predicted) of the diffusing capacity for carbon monoxide is always indicative of severe widespread emphysema. No relationship was found between hemodynamic data and peripheral wedge angiographic findings. Some agreement resulted between the chest x-ray film and peripheral wedge angiographic abnormalities only in patients with type-A chronic obstructive pulmonary disease; on the contrary, in patients with type-B chronic obstructive pulmonary disease, both false-positives and false-negatives were noted.