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58.28 743.924 94.45 -0.85 re
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BT
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11.955 0 0 11.955 58.28 745.738 Tm
0.0206 Tc
[(POINT)-323.8(O)-1.2(F)-333(V)-1(IEW)]TJ
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[(Is)-334(pulmonary)-334(e)-0.1(mbolism)-334.8(a)-334(common)-336.5(cause)-334(of)-333(chronic)-330.2(p)-2.6(ulmonary)]TJ
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[(hypertension?)-332.7(L)1.2(imitations)-334(of)-333(the)-334(e)-0.1(mbolic)-334(hypothesis)]TJ
/F3 1 Tf
10.959 0 0 10.959 219.912 660.075 Tm
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[(P.)-330.8(Egermayer)]TJ
/F4 1 Tf
6.1509 0 TD
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(*)Tj
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0.4966 0 TD
[(,)-334.6(A.J.)-330.9(Peacock)]TJ
/F4 1 Tf
6.4923 0 TD
(**)Tj
/F5 1 Tf
8.966 0 0 8.966 58.28 623.225 Tm
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/F6 1 Tf
22.5159 0 TD
(#)Tj
/F5 1 Tf
0.999 0 TD
[(ERS)-334.2(Journals)-335.6(Ltd)-328.2(2000.)]TJ
/F7 1 Tf
-23.5149 -1.0559 TD
[(ABSTRACT)66.7(:)-310.3(The)-311.4(hypothesis)-318.6(that)-308.3(chronic)-305.1(thromboembolic)-304.4(pulmonary)-316.2(hypertension)]TJ
T*
[(results)-354.4(from)-359.6(unre)11.6(solved)-365.6(pulmonary)-366.8(embolism)-367.9(has)-365(str)12.2(ongly)-365.2(influenced)-367.3(the)-364.5(diagnosis)]TJ
T*
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T*
[(induce)-310.8(chron)12.2(ic)-311(pulmonary)-309.9(hypertension)-314.5(in)-309.8(any)-306.9(animal)-316.9(species)-308.9(by)-307.4(means)-313.6(of)-309.8(r)13.4(epeated)]TJ
T*
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T*
[(pulmonary)-436.4(embolism)-431.1(of)-436.2(differen)9.6(t)-436.7(degree)11.7(s)-437(o)0(f)-429.9(magnitude)-437.3(have)-432.6(also)-431.5(been)-431(studied)-432.8(in)]TJ
T*
[(humans)-297.8(and)-299.1(there)-293.5(is)-299.7(little)-303(to)-297.1(suggest)-301.6(that)-295.7(chronic)-292.5(pulmonary)-297.3(hypertension)-301.9(is)-299.7(a)-303(likely)]TJ
T*
[(long)-593.3(term)-587(outcome.)-593.2(Furthermore)-583.3(many)-591.4(conditions)-591.7(which)-594.4(pr)15.3(edispose)-591.8(to)-594.3(venous)]TJ
T*
[(thromb)11(oembolism)-297.8(do)-288.4(not)-288.9(appear)-290.8(to)-290.8(cause)-294(thr)14.8(omboembolic)-293.9(pulmonary)-290.9(hypertension.)]TJ
T*
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T*
[(chron)12.2(ic)-538.6(thromb)11(oembolic)-536.7(pulmonary)-537.5(hypertension,)-538.7(but)-534.1(not)-535.5(in)-531.1(those)-535.4(with)-540.6(venous)]TJ
T*
[(thromb)11(osis,)-334.4(suggesting)-339(that)-333.6(these)-332.9(may)-334.1(be)-332.5(unrelated)-328.9(conditions.)]TJ
0.999 -1.0559 TD
[(Thro)11.6(mbosis)]TJ
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5.5325 0 TD
[(in)-467.9(situ)]TJ
/F7 1 Tf
3.2373 0 TD
[(of)-474.2(the)-465.7(pulmonary)-474.3(arteries)-473.8(is)-470.5(common)-470.4(in)-467.9(severe)-458.8(pulmonary)]TJ
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0 -1.0559 TD
[(pulmonary)-512.2(embolism.)-516.2(It)-519.6(is)-514.7(hypothesized)-510.5(that)]TJ
/F1 1 Tf
20.638 0 TD
[(in)-512.1(situ)]TJ
/F7 1 Tf
3.3258 0 TD
[(thrombosis)-510.2(and)-507.8(pulmonary)]TJ
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[(arteriopathy)-304.5(are)-295.2(common)-299.7(causes)-301(of)-303.5(vascular)-294.8(occlusion)-301.6(which)-303.6(is)-306.1(usually)-303.1(diagnosed)-304.3(as)]TJ
T*
[("chr)11.6(onic)-295.9(thr)14.8(omboembolic)-293.9(pulmonary)-290.9(hypertension")-293.6(and)-292.8(that)-289.3(venous)-292.3(thr)14.8(omboembo-)]TJ
T*
[(lism)-219.4(is)-223.9(unlikely)-219.9(to)-221.3(be)-218.6(a)-220.8(common)-217.5(cause)-224.4(of)-214.9(chronic)-216.6(pulmonary)-215.1(hypertension.)-222.6(It)-222.5(is)-217.6(further)]TJ
T*
[(hypothesized)-668.6(that)-668.7(pulmonary)-670.3(embolism)-665.1(is)-666.5(seldom)-669.6(the)-668(sole)-665.2(cause)-667(of)-670.2("chr)11.6(onic)]TJ
T*
[(thromb)11(oembolic)-340.7(pulmonary)-335.2(hypertension".)]TJ
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T*
[(Eur)-331.9(Respir)-333.8(J)-334.4(2000;)-333.5(15:)-334.6(440\261448.)]TJ
/F4 1 Tf
7.97 0 0 7.97 401.499 624.189 Tm
[(*The)-697.5(Canterbury)-695.7(Respiratory)-697.2(Research)]TJ
0 -1.0599 TD
[(Group,)-339.6(Christchur)11(ch)-343.3(School)-335.1(of)-344.5(Medicine,)]TJ
T*
[(Christchur)11(ch,)-498.8(New)-495.6(Zealand.)-491.3(**)-493.7(Scottish)]TJ
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[(Pulmonary)-279.4(V)106.3(ascular)-284.8(Unit,)-282.3(Dept)-287.1(of)-287.6(Respir)19.4(-)]TJ
0 -1.0599 TD
[(atory)-375.2(Medicine,)-374.2(W)76.3(estern)-380.3(Infirmary)66.3(,)-376(Glas-)]TJ
0 -1.067 TD
[(gow)67.8(,)-333.3(G)0(1)37.3(1)-332.2(6NT)72.2(,)-326.2(UK.)]TJ
0 -2.1197 TD
[(Corresponde)11.8(nce:)-646.4(P)111(.)-646.3(Egermayer)40(,)-646.3(Canter)14.5(-)]TJ
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[(bury)-205.2(Respiratory)-206.4(Research)-205.7(Group,)-211.6(PO)-209.5(Box)]TJ
0 -1.0599 TD
[(4015,)-531.1(Christchurch)9.1(,)-546.7(New)-538.3(Zealand)12.7(.)-546.7(Fax:)]TJ
T*
[(6433641)43.2(184)]TJ
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[(Keywords)11.5(:)-334.6(Chronic)-325.9(thromboemb)11.8(olic)]TJ
0 -1.067 TD
[(pulmonary)-324.3(hypertensio)11.9(n)]TJ
0 -1.0599 TD
[(pathophysiolo)12.9(gy)]TJ
T*
[(pulmonary)-324.3(arteriopa)9.7(thy)]TJ
0 -1.067 TD
[(pulmonary)-324.3(atherosclero)8.7(sis)]TJ
0 -1.0599 TD
[(pulmonary)-324.3(embolism)]TJ
T*
[(pulmonary)-324.3(hypertensio)11.9(n)]TJ
0 -2.1268 TD
[(Received:)-327.9(May)-326.1(18)-330.1(1999)]TJ
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[(Accepted)-183.2(after)-189.4(revision)-180.4(November)-183.3(29)-187.9(1999)]TJ
9.963 0 0 9.963 68.258 366.916 Tm
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[(ri)17.3(gh)15.5(t)-327.5(v)0(e)15.1(n)0(t)18.9(r)0(i)17.3(c)0(u)15.1(l)0(a)18.4(r)-332.4(hy)21.2(pe)15.1(rt)17.3(ro)19.6(ph)15.5(y)73.2(,)-330.4(an)15.1(d)-330.8(r)0(i)17.3(g)0(h)15.5(t)-327.5(he)15.1(ar)19.2(t)-333.2(f)0(a)19.2(i)0(l)16.5(u)0(r)13.9(e)-331.2(ha)20.8(ve)]TJ
T*
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T*
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T*
[(primary)-418.5(pathol)-9.7(ogical)-414.2(changes)-417.5(in)-413.6(the)-414.8(pulmonary)-418.4(vessel)-10.1(s)]TJ
0 -1.0698 TD
[([2].)-478.2(In)-475.4(1953)-475.4(O)]TJ
6.974 0 0 6.974 121.663 313.398 Tm
0.0001 Tc
(WEN)Tj
/F5 1 Tf
9.963 0 0 9.963 142.186 313.398 Tm
0 Tc
[(et)-470.9(a)-6.5(l)0(.)]TJ
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2.6746 0 TD
[([3])-477.8(were)-476(among)-479.7(the)-477.4(first)-479.6(to)]TJ
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T*
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T*
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T*
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T*
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T*
[(matic)-251.5([4,)-253.9(5].)-248.2(Majo)-7.8(r)-247.1(occlusion)-258.3(of)-247.8(the)-249.8(pulmonary)-259.1(arteries)-255.5(in)]TJ
T*
[(associ)-10.1(ation)-526.8(with)-529.6(chroni)-9(c)-524.7(P)0(H)-528.2(i)0(s)-522.9(esti)-9.4(mated)-528(to)-527.4(occur)-529.8(in)]TJ
T*
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T*
[(eviden)-7.8(ce)-275.5(of)-276.3(recent)-282.9(or)-276.3(o)-6.5(l)0(d)-277.1(pulmonary)-281.8(embol)-9.7(ism)-276.5(\(PE)-7.2(\))-275.5(may)]TJ
T*
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1.0015 -1.0471 TD
[(In)-617.7(mo)18.1(de)20.8(rn)-617.7(te)18.4(rm)16.5(in)13.2(ol)18.9(og)21.2(y)-626.7(t)0(h)18.9(e)-621.4(di)13.2(se)19.6(as)19.6(e)-627.1(e)0(n)20.8(t)0(i)16.5(t)0(y)-618.5(")13.3(ch)15.1(ro)19.6(ni)13.2(c)]TJ
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T*
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T*
[(an)15.1(d)-285.3(r)0(e)19.2(c)0(e)14.7(n)0(t)-277.1(r)0(e)13.5(v)0(i)18.9(e)0(w)16.9(s)-286.5(co)15.1(ns)20(id)18.9(er)-282.4(th)18.9(is)-278.2(oc)15.1(cl)18.4(us)20(io)13.2(n)-285.3(t)0(o)-277.1(b)0(e)-280.8(p)0(r)19.6(i)0(m)15.7(a)0(r)13.5(i)0(l)16.5(y)]TJ
T*
[(or)-589.3(so)14.4(le)18.4(ly)-590(th)18.8(e)-598.7(r)0(e)13.5(s)0(u)20(l)0(t)-592.4(o)0(f)-589.2(v)0(e)20.8(n)0(o)15.5(u)0(s)-588.8(t)0(h)18.8(r)0(o)13.9(m)0(b)18.1(o)0(e)15.1(m)13.2(bo)15.5(li)16.5(sm)]TJ
/F5 1 Tf
21.3908 0 TD
[(e.)21.2(g.)]TJ
/F4 1 Tf
3.807 21.4761 TD
[("C)13.6(T)12.2(E)0(P)17.9(H)-243.7(is)-227(th)13.2(e)-234.5(r)0(e)13.5(s)0(u)20(l)0(t)-233.9(o)0(f)-225.1(s)0(i)17.7(n)0(g)15.5(l)0(e)-231.9(o)0(r)-230.8(r)0(e)19.2(c)0(u)15.1(r)0(r)18(e)0(n)20.8(t)-242.1(pu)21.2(lm)15.7(on)15.5(ar)19.2(y)-239.8(e)0(m)17.7(-)]TJ
0 -1.0641 TD
[(bo)15.5(li)-211.1(ar)13.5(is)17.7(in)18.8(g)-222.7(f)0(r)18(o)0(m)-215.2(s)0(i)17.7(t)0(e)18.4(s)-223.9(of)-208(ve)15.1(no)15.5(us)-207.6(th)13.2(ro)19.6(mb)18.1(os)14.4(is)17.7(")-220([)0(9)19.6(])0(.)-236.1(The)-234.4(term)]TJ
T*
[("chr)-8(onic)-335.9(PE")-338.6(is)-340.8(also)-337.1(freque)-8.6(ntly)-337.9(empl)-9(oyed)-339.2(as)-333.2(a)-336.9(synonym)]TJ
T*
[(for)-324.2(CTE)-9.6(PH)-317.7(a)-6.9(lthough)-323.1(the)-323.7(more)-326.9(descri)-10.6(ptive)-322(term)-329.3("chronic)]TJ
T*
[(maj)-8.2(or)-486.8(v)-6.5(essel)-493.1(thromboem)-11.8(bolic)-492.7(PH")-492.1(may)-495.2(be)-491.3(preferable,)]TJ
T*
[(provi)-7.8(ded)-406.7(it)-404.6(is)-409.1(unders)-7.8(tood)-403.8(that)-412.3(the)-403.4(term)-408.9("t)-6.9(hromboemb)-9.5(o-)]TJ
T*
[(lis)-8.2(m")-280.8(may)-290.4(also)-285.9(include)-289.7(cases)-286.2(of)-282(pulm)-8.6(onary)-284.7(artery)-289.8(throm-)]TJ
T*
[(bosis)-8.6(.)]TJ
1.0015 -1.0528 TD
[(A)-323.4(g)0(r)19.6(e)0(a)14.7(t)-316.1(de)15.1(al)-305.9(of)-310.4(co)15.1(nf)19.6(us)14.4(io)18.9(n)-319.4(i)0(n)-311.2(t)13.9(hi)13.2(s)-314.9(a)0(r)13.5(e)0(a)-309.6(o)0(f)-310.4(m)0(e)17.7(d)0(i)18.9(c)0(i)18.5(n)0(e)-309.2(d)0(e)15.1(r)20.4(-)]TJ
-1.0015 -1.0641 TD
[(iv)13.2(es)-190.9(fr)18(om)-198.2(hi)18.9(st)17.7(or)13.9(ic)18.4(al)-192.1(te)12.8(rm)16.5(in)18.9(ol)18.9(og)15.5(y)73.2(,)-199.6(pa)15.1(rt)17.3(ic)18.4(ul)18.9(ar)13.5(ly)-191.7(wi)14.9(th)-191.7(re)13.5(ga)20.8(rd)-196.6(to)]TJ
T*
[(th)13.2(e)-285.7(t)0(e)18.4(r)0(m)16.5(s)-286.5("p)18.3(ri)17.3(ma)17.7(ry)13.9(")-282.6(a)0(n)15.1(d)-285.3("s)17.1(ec)14.7(on)21.2(da)15.1(ry)19.6(")-288.2(P)11.4(H.)-278.2(In)-276.3(th)13.2(e)-285.7(p)0(a)20.8(s)0(t)-278.2(")0(p)18.3(r)0(i)17.3(-)]TJ
T*
[(ma)12(ry)-452.7(P)11.4(H)0(")-458(h)0(a)20.8(s)-462.9(be)15.1(en)-451.5(re)13.5(ga)20.8(rd)13.9(ed)-451.5(as)-458.4(a)-462.1(d)0(i)18.9(s)0(t)17.7(i)0(n)18.9(c)0(t)-453.9(p)0(a)15.1(t)0(h)18.9(o)0(l)18.8(o)0(g)15.5(i)0(c)18.4(a)0(l)]TJ
T*
[(en)15.1(ti)16.5(ty)-470.5(ch)20.8(ar)13.5(ac)20.4(te)12.8(ri)17.3(ze)20.4(d)-478.8(b)0(y)-468.2(p)0(l)13.2(e)0(x)20.8(i)0(f)17.3(o)0(r)14(m)-476.2(ar)13.5(te)18.4(ri)17.3(op)15.5(at)18.4(hy)-468.2([1)13.9(0,)-479.2(1)33.4(1].)]TJ
T*
[(How)-10.2(ever)28.7(,)-336.1(more)-343.9(recent)-9.8(ly)-339.7(prim)-10.2(ary)-340(PH)-340.4(has)-339.6(come)-348.4(to)-339.7(be)-337.7(re-)]TJ
T*
[(garded)-348.4(as)-344.6(a)-342.6(diagno)-7.4(sis)-342.8(of)-344.6(exclusion,)-349.7(and)-344.1(the)-340.8(term)-352("unex-)]TJ
T*
[(plai)-8.2(ned)-372.6(PH")-372.6(woul)-9.4(d)-370.7(b)0(e)-371.8(more)-372.4(appropr)-8.9(iate)-8.6(.)-370.3(I)0(t)-369.7(has)-373.8(becom)-7.8(e)]TJ
0 -1.0698 TD
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[(was)-258.2(not)-255.1(infl)-9.4(uenced)-256.2(by)-257.6(antic)-9.4(oagulant)-262.1(treatmen)-11.1(t)-253.5(over)-261.1(6)]TJ
-1.6844 -1.0471 TD
[(month)-9.3(s)-314.9(i)0(n)-316.9(a)-314.2(recent)-322.7(random)-9.7(ized)-319.2(contr)-8.2(olled)-322(trial)-320.2([30].)-319.6(The)]TJ
0 -1.0527 TD
[(benefi)-9.4(cial)-293.1(effects)-292.2(of)-293.3(hepari)-9.4(n)-291(i)0(n)-294.1(the)-295.3(treat)-11(ment)-293.5(of)-293.3(PE)-295.1(relat)-11(e)]TJ
0 -1.0471 TD
[(to)-345.3(prevent)-10.1(ion)-346.1(of)-344.6(recurrence)-355.9(and)-344.1(not)-346.1(to)-345.3(any)-344.1(thrombo)-12.5(lytic)]TJ
0 -1.0527 TD
[(proper)-8.2(ties.)-231.7(Con)-7(sequent)-9.7(ly)-225.8(the)-232.7(au)-7.6(thors)-230.9(consi)-7.8(der)-231.9(the)-232.7(sugges)-7.4(-)]TJ
0 -1.0471 TD
[(tion)-292.3(that)-298.4(CTEPH)-293.1(mig)-7.8(ht)-288.4(resul)-9.4(t)-287.7(from)-299.6(the)-289.6(persi)-9.4(stence)-293.9(of)-293.3(PE)]TJ
0 -1.0528 TD
[(in)-385.2(patie)-9.4(nts)-381.4(in)-385.2(whom)-391.4(antic)-9.4(oagulant)-387.2(thera)-8.6(py)-382.8(has)-390.8(been)-385.1(in-)]TJ
0 -1.0471 TD
[(appropr)-8.9(iately)-342.6(withheld)-341.9(to)-334(be)-337.7(somewha)-8.7(t)-333.2(unli)-7.8(kely)62.4(.)]TJ
1.0015 -1.0528 TD
[(It)-284.3(ha)15.1(s)-292.2(a)0(l)18.4(s)0(o)-287.2(b)0(e)20.8(e)0(n)-286.5(p)0(o)15.5(s)0(t)17.7(u)0(l)18.9(a)0(t)18.5(e)0(d)-286.5(t)0(h)18.9(a)0(t)-283.1(s)0(o)14.4(m)0(e)-283.9(c)0(a)14.7(s)0(e)19.6(s)-292.2(of)-287.7(ac)20.4(ut)18.9(e)-297.1(P)11.4(E)]TJ
-1.0015 -1.0471 TD
[(pr)19.6(og)15.5(re)19.2(ss)-225.8(to)-225.8(CT)18.1(EP)17.9(H)-238(b)0(e)20.8(c)0(a)14.7(u)0(s)20(e)-234.5(of)-225.1(a)-234.5(f)0(a)13.5(i)0(l)16.5(u)0(r)19.6(e)-234.5(of)-213.7(fi)17.3(br)13.9(in)18.9(ol)18.9(ys)20(is)17.7(,)-233.7(b)0(u)15.5(t)]TJ
0 -1.0528 TD
[(de)15.1(fe)19.2(ct)18.4(s)-525.5(i)0(n)-521.8(f)0(i)17.3(b)0(r)19.6(i)0(n)18.9(o)0(l)18.9(y)0(s)14.4(i)0(s)-517.2(h)0(a)20.8(v)0(e)-519.8(s)0(e)19.6(l)0(d)13.2(o)0(m)-516.8(b)0(e)20.8(e)0(n)-519.8(d)0(e)20.8(m)0(o)12.4(n)0(s)20(t)0(r)17.3(a)0(t)18.4(e)0(d)]TJ
0 -1.0471 TD
[(am)17.7(on)15.5(g)-285.3(p)0(a)15.1(t)0(i)22.2(e)0(n)15.1(t)0(s)-278.2(w)0(i)14.9(t)0(h)-277.1(C)11.6(TE)13(P)11.4(H)-289.2([3)19.6(1,)-285.7(3)-6.5(2].)-293.7(Lon)-6.4(g)-296.7(term)-300.8(follow)-9.2(-)]TJ
25.1977 66.1583 TD
[(up)-263.3(of)-264.9(patients)-265.6(with)-267.8(acute)-263.5(PE)-260.9(has)-265.7(usually)-267.8(failed)-267.8(to)-260(ident)-9(ify)]TJ
0 -1.0698 TD
[(any)-315.7(who)-313.5(proceed)-315.4(to)-311.2(CTEP)-9.5(H)-306.3([33\26136])-8.5(.)-313.4(Cases)-313.3(of)-310.4(acute)-314.7(PE)]TJ
0 -1.0641 TD
[(whi)-8.6(ch)-258(a)-6.9(pparently)-270.1(resulted)-270.5(in)-260(CTEPH)-270.3(have)-265.6(been)-259.9(report)-10.6(ed,)]TJ
0 -1.0698 TD
[(add)-8.4(ing)-403(to)-407.9(the)-409.1(impressi)-12.7(on)-405.6(that)-406.6(this)-407.3(is)-409.1(a)-405.2(well)-410.5(estab)-8.2(lished)]TJ
T*
[(phe)-8.4(nomenon.)-259.6(But)-259.8(these)-258.6(were)-259.8(alm)-8.2(ost)-256.2(all)-257.8(patients)-259.9(in)-260(whom)]TJ
T*
[(the)-249.8(pulmonary)-253.4(artery)-250(pressure)-251.5(measured)-252.3(at)-243.3(the)-244.1(time)-250.4(of)-242.1(the)]TJ
0 -1.0641 TD
[(acu)-8.8(te)-362.8(event)-371.2(was)-366.3(in)-362.4(excess)-372.4(of)-367.3(40)-360(mm)-7.8(Hg)-364([37,)-368.5(38].)-368.5(It)-364(has)]TJ
0 -1.0698 TD
[(subseq)-7.4(uentl)-9(y)-313.7(been)-316.8(establis)-10.7(hed)-315.7(that)-315.5(the)-318.1(normal)-319.4(right)-317.5(ven-)]TJ
T*
[(tri)-8.6(cle)-403.8(is)-403.4(una)-8.4(ble)-403.4(to)-402.3(g)-6.5(enerate)-409.3(press)-8.2(ures)-404.6(of)-407.2(this)-407.3(magnitud)-8.7(e)]TJ
0 -1.0641 TD
[(acu)-8.8(tely)60.1(,)-245.1(s)0(o)-247.4(these)-247.2(must)-248.8(most)-9.8(ly)-242.9(have)-248.6(bee)-8.8(n)-239.8(p)-6.5(atients)-247.8(who)-250.9(had)]TJ
0 -1.0698 TD
[(PH)-351.8(prior)-356.5(to)-345.3(the)-352.2(PE)-352(in)-345.3(quest)-7.8(ion)-351.8([39].)-353.7(Previous)-352.3(PE)-352(might)]TJ
T*
[(exp)-8.4(lain)-332.6(this)-9(,)-330.4(but)-340.4(many)-336.7(other)-338.2(causes)-338.2(are)-340.4(also)-337.1(possible.)]TJ
1.0015 -1.0471 TD
(R)Tj
6.974 0 0 6.974 325.871 644.145 Tm
0.0001 Tc
[(EM)17.7(Y)]TJ
9.963 0 0 9.963 340.044 644.145 Tm
0 Tc
(-J)Tj
6.974 0 0 6.974 346.904 644.145 Tm
0.0001 Tc
[(ARD)21.1(IN)]TJ
/F5 1 Tf
9.963 0 0 9.963 372.019 644.145 Tm
0 Tc
[(et)-334.4(al)18.9(.)]TJ
/F4 1 Tf
2.3843 0 TD
[([4)14(0])-338.9(studi)-9.8(ed)-349.1(the)-357.9(evolution)-361.5(of)-350.2(acute)]TJ
-8.6781 -1.0698 TD
[(mass)-9(ive)-266.8(PE)-266.6(in)-265.7(62)-269(patients)-271.3(over)-272.5(the)-266.8(course)-269.9(of)-270.6(a)-262.9(year)-267.2(using)]TJ
T*
[(spir)-8.2(al)-334.4(compu)-7.4(ted)-335.1(tomography)-339.5(\(C)-7.8(T\))-331.6(angiog)-7.4(raphy)56.8(.)-330.4(This)-340.8(al-)]TJ
T*
[(low)-8.6(ed)-497(visua)-7.8(lization)-505.8(of)-498.2(smaller)-506.2(arteries)-505.8(distal)-502.7(to)-499(major)]TJ
0 -1.0641 TD
[(occ)-8.8(lusions,)-399.8(which)-397.5(is)-392.1(usual)-7.8(ly)-390.9(not)-397.3(possible)-400.6(with)-393(stand)-7.8(ard)]TJ
0 -1.0698 TD
[(pulm)-8.6(onary)-273.3(ang)-8.4(iography)57.8(.)-273.5(They)-275(found)-272.9(compl)-9.7(ete)-272.9(resol)-9.4(ution)]TJ
T*
[(in)-345.3(30)-343(patients)-345.3(\(48%\))-9.4(.)-341.8(I)0(n)-338.9(a)-342.6(furt)-8.6(her)-340(24)-343(patients)-351(with)-341.8(more)]TJ
0 -1.0641 TD
[(extens)-9(ive)-494.5(vascul)-9(ar)-492.9(occlus)-9(ion)-494.1(at)-493.7(the)-494.5(time)-500.7(of)-492.5(diagno)-7.4(sis,)]TJ
0 -1.0698 TD
[(there)-253.3(was)-246.8(incom)-9.8(plete)-248.4(resolu)-10.1(tion)-246.8(leading)-249.9(to)]TJ
/F8 1 Tf
17.0489 0 TD
(>)Tj
/F4 1 Tf
0.552 0 TD
[(50%)-249.3(narrow-)]TJ
-17.6009 -1.0698 TD
[(ing)-431.5(o)-6.5(f)-429.2(the)-431.9(pulmonary)-441.2(arteries,)-437.9(and)-429.5(the)-431.9(de)-7.6(velopment)-436.7(of)]TJ
T*
[(chroni)-9(c)-433.7(P)0(H)-437.2(i)0(n)-436.4(five)-439.9(cases.)-440.3(The)-439.3(patients)-442(who)-438.7(develo)-7.8(ped)]TJ
0 -1.0641 TD
[(chroni)-9(c)-382.4(P)0(H)-385.9(all)-383(had)-384(chronic)-385.7(arter)-10.2(iopathic)-389.6(changes)-389(at)-379.9(the)]TJ
0 -1.0698 TD
[(time)-409.7(of)-401.5(initial)-404.6(presen)-8.2(tation.)-405.2(Anot)-9.4(her)-402.6(eight)-401.6(pati)-8.2(ents)-399.7(who)]TJ
T*
[(had)-298.6(newly)-295.1(develo)-7.8(ped)-292.9(featu)-8.6(res)-290(of)-293.3("chr)-8(onic)-290.4(PE")-298.8(at)-288.8(foll)-9.4(ow-)]TJ
T*
[(up)-394.2(did)-391.6(not)-391.6(have)-390.8(echocard)-9.3(iogra)-8.2(phic)-392.8(eviden)-7.8(ce)-389.3(of)-390.1(chroni)-9(c)]TJ
0 -1.0641 TD
[(PH.)-323.7(Using)-318.6(this)-322(novel)-319.6(and)-315.7(ap)-7.6(parently)-320.6(highl)-8.6(y)-313.8(sensi)-9(tive)-315.5(in-)]TJ
0 -1.0698 TD
[(vesti)-10.2(gational)-349.8(technique)-348.6(these)-343.9(author)-9(s)-337.7(have)-345.3(demon)-7.4(strated)]TJ
T*
[(that)-412.2("chron)-9.5(ic)-402.7(PE")-412.6(need)-407.9(not)-408.7(necess)-8.2(arily)-408.9(be)-406(synonym)-9.7(ous)]TJ
0 -1.0641 TD
[(wi)-7.8(th)-334(chroni)-9(c)-331.2(PH.)]TJ
1.0015 -1.0528 TD
[(No)11.6(nr)19.6(es)19.6(ol)13.2(ut)18.9(io)18.9(n)-285.3(o)0(f)-282(c)0(l)18.5(i)0(n)18.8(i)0(c)18.5(a)0(l)12.8(l)0(y)-277.1(s)0(u)20(s)0(p)14.4(e)0(c)20.4(t)0(e)12.8(d)-285.3(ma)17.7(ss)18.9(iv)13.2(e)-285.7(a)0(c)14.7(u)0(t)18.8(e)-285.7(PE)]TJ
-1.0015 -1.0698 TD
[(ha)15.1(d)-177.2(p)0(r)19.6(e)0(v)15.1(i)0(o)18.8(u)0(s)20(l)0(y)-168.9(b)0(e)20.8(e)0(n)-167(r)0(e)13.5(p)0(o)21.2(r)0(t)17.3(e)0(d)-167(i)0(n)-168.9(t)0(h)18.9(r)0(e)13.5(e)-171.9(yo)15.5(un)21.2(g)-177.2(f)0(e)19.2(m)0(a)12(l)0(e)-163.6(p)0(a)15.1(t)0(i)16.5(e)0(n)20.8(t)0(s)]TJ
0 -1.0641 TD
[(wh)17.3(o)-154.4(w)0(e)11.2(r)0(e)-145.8(f)0(o)19.6(l)0(l)16.5(o)0(w)17.3(e)0(d)-144.2(f)0(o)14(r)-150.3(up)-149.5(to)-146.2(7)-154.4(y)0(r)19.6(s)-155.6([4)19.6(1].)-157.1(In)-168.2(two)-167.9(of)-162.5(these)-167.5(c)-6.9(ases)]TJ
0 -1.0698 TD
[(the)-283.9(pulm)-8.6(onary)-284.6(artery)-289.8(pressure)-285.6(at)-283.1(rest)-287.5(and)-281.5(foll)-9.4(owing)-283.3(exer-)]TJ
T*
[(cise)-263.5(was)-252.5(no)-7.2(rmal)-255.3(at)-260.4(follow-up.)-263.8(In)-253.5(the)-255.5(thir)-9.4(d)-251.1(case)-261.5(the)-255.5(resting)]TJ
T*
[(press)-8.2(ure)-260.4(at)-260.4(follow)-9.2(-up)-260(was)-263.9(the)-261.2(same)-264.3(as)-259.2(at)-260.4(baseline,)-264(but)-260.7(the)]TJ
0 -1.0641 TD
[(post-)-9(exerci)-9.8(se)-418.5(mean)-422.4(pulm)-8.6(onary)-421.2(arter)-10.2(y)-416.2(press)-8.2(ure)-419.7(was)-423.2(ele-)]TJ
0 -1.0698 TD
[(vated)-240.3(to)-231.5(45)-229.2(mm)-7.8(Hg,)-233.5(howe)-7.4(ver)-231.9(an)-229.6(ex)-7.6(ercise)-232.9(test)-237(had)-236(not)-232.3(been)]TJ
T*
[(perfor)-9.8(med)-387.1(at)-379.9(basel)-8.2(ine.)-381(The)-6.8(se)-378.7(cases)-388.7(confirm)-390(the)-380.7(impres-)]TJ
0 -1.0641 TD
[(sion)-279.8(that)-281.4(persisti)-11.9(ng)-274.7(acute)-280.6(maj)-8.2(or)-276.3(occlusion)-281.1(o)-6.5(f)-275.5(the)-278.2(pulmon-)]TJ
0 -1.0698 TD
[(ary)-482.3(arteries)-483.1(does)-477(not)-477(usual)-7.8(ly)-476.2(by)-473.8(itself)-481.5(account)-481.2(for)-477.8(the)]TJ
T*
[(dev)-8.4(elopment)-248.1(of)-247.8(chroni)-9(c)-240.2(PH,)-249.7(other)-247.2(pre-ex)-8.6(isting)-246.2(facto)-8.6(rs)-243.3(are)]TJ
T*
[(gen)-8.4(erally)-319(invol)-8.6(ved.)-316.1(Fu)-6.4(rthermor)-11.1(e,)-314.5(acute)-320.4(PE)-317.8(is)-318.1(often)-321.2(diag-)]TJ
0 -1.0641 TD
[(nosed,)-335.8(and)-332.7(possibly)-331.9(mis)-9(diagnosed,)-336(in)-328.3(pati)-8.2(ents)-331.4(who)-330.6(have)]TJ
0 -1.0698 TD
[(pre-ex)-8.6(isting)-343(pulmonary)-344.4(artery)-341(pathology)56.3(.)]TJ
1.0015 -1.0527 TD
[(Do)11.6(gs)-366.9(ha)15.1(ve)-371.8(be)20.8(en)-371.8(th)18.9(e)-382.4(m)0(o)18.1(s)0(t)-369.3(f)0(r)18(e)0(q)15.1(u)0(e)15.1(n)0(t)-368.1(s)0(u)20(b)0(j)13.2(e)0(c)20.4(t)0(s)-369.3(o)0(f)-373(e)0(x)15.1(p)0(e)20.8(r)0(i)17.3(-)]TJ
-1.0015 -1.0641 TD
[(me)12(nt)18.9(al)-510.8(P)11.4(E)0(.)-511.7(O)0(l)20.6(d)0(e)15.1(r)-520.2(do)21.2(gs)-509.2(ar)13.5(e)-519(s)0(u)20(s)0(c)19.6(e)0(p)15.1(t)0(i)16.5(b)0(l)18.8(e)-519(to)-510.4(sp)20(on)15.5(ta)18.4(ne)15.1(ou)21.2(s)]TJ
0 -1.0698 TD
[(th)13.2(ro)19.6(mb)18.1(oe)15.1(mb)18.1(ol)18.9(ic)-220.6(di)13.2(se)19.6(as)19.6(e,)-223.5(pa)15.1(rt)17.3(ic)18.4(ul)18.9(ar)19.2(ly)-225.8(w)12.4(h)0(e)15.1(n)-228.4(th)18.9(er)13.5(e)-228.8(i)0(s)-221.3(c)0(o)15.1(m)0(o)18.1(r)20.4(-)]TJ
T*
[(bi)13.2(di)18.9(ty)-277.1([4)19.6(2].)-288(In)-293.3(this)-299.2(speci)-8.2(es,)-293.7(imp)-7.8(action)-300.4(of)-293.3(large)-293.1(thrombi)-299.4(in)]TJ
T*
[(the)-369.3(pulmon)-10.1(ary)-362.8(arter)-10.2(ies)-364.8(causes)-372.4(hypoxaem)-10.1(ia,)-363.2(but)-368.9(no)-365.7(noti-)]TJ
0 -1.0641 TD
[(ceab)-10(le)-442.5(cardi)-8.6(ovascul)-9.7(ar)-441.7(effects)-445.8(and)-446.6(only)-449.3(very)-448.9(minor)-449.1(and)]TJ
0 -1.0698 TD
[(trans)-9.4(ient)-378.1(increases)-384.7(in)-373.8(pulmonary)-378.6(arter)-10.2(y)-370.7(press)-8.2(ure)-374.2([43].)-376.5(It)]TJ
T*
[(has)-339.6(been)-333.9(sugges)-7.4(ted)-335.1(that)-338.3(dogs)-334.3(may)-335.9(be)-337.7(poor)-334.7(experi)-9.4(mental)]TJ
0 -1.0641 TD
[(model)-9.7(s)-235.3(for)-238.8(CTEPH)-241.8(due)-236(to)-237.2(a)-234.5(more)-235.8(ac)-8(tive)-235.8(fibrinol)-10.7(ytic)-235.8(path-)]TJ
0 -1.0698 TD
[(way)-268.4(than)-261.9(human)-7.4(s.)-264.1(While)-266.2(the)-266.8(evidence)-266.2(for)-267.3(this)-265.1(hypoth)-7(esis)]TJ
T*
[(has)-214.4(been)-214.4(quest)-7.8(ioned,)-211.8(it)-216.8(cannot)-212.6(be)-212.5(enti)-8.2(rely)-212.3(disco)-7.8(unted)-211.5([44].)]TJ
T*
[(CTE)-9.6(PH)-283.5(canno)-10.3(t)-282(b)0(e)-286.5(induce)-7.8(d)-285.3(i)0(n)-288.4(dogs)-288.8(by)-286.1(large)-281.7(thrombi)-9.1(,)-284.9(un-)]TJ
0 -1.0641 TD
[(less)-361(the)-363.6(dogs)-357.1(have)-362.4(been)-356.7(treate)-12.2(d)-353.6(with)-358.9(trane)-8.6(xami)-9(c)-354(acid)-359.1(to)]TJ
0 -1.0698 TD
[(inhi)-7.8(bit)-337.1(fibrinol)-10.7(ysis)-337.9([45].)]TJ
1.0015 -1.0527 TD
[(In)-196.6(su)20(mm)14.9(ar)19.2(y)67.5(,)-199.6(th)18.9(e)-200.3(a)0(u)15.1(t)0(h)18.9(o)0(r)19.6(s)-201.1(ar)19.2(e)-206(n)0(o)21.2(t)-202.3(aw)16.9(ar)19.2(e)-200.3(o)0(f)-196.6(a)0(n)20.8(y)-199.9(co)15.1(nv)21.2(in)13.2(ci)18.5(ng)]TJ
-1.0015 -1.0641 TD
[(ev)15.1(id)18.8(en)15.1(ce)-321(th)13.2(at)-323(a)-331.2(s)0(i)17.7(n)0(g)15.5(l)0(e)-323(m)0(a)17.7(j)0(o)18.9(r)-338.1(P)11.4(E)-334.9(pr)19.6(og)15.5(re)19.2(ss)18.9(es)-327.5(to)-322.6(CT)18.1(EP)17.9(H)-334.8(i)0(n)]TJ
0 -1.0698 TD
[(hu)15.5(ma)17.7(ns)-315.7(or)-316.1(in)-316.9(ot)18.9(he)20.8(r)-326.7(s)0(p)20(e)0(c)14.7(i)0(e)18.5(s)0(.)]TJ
8.966 0 0 8.966 523.049 797.499 Tm
(441)Tj
7.472 0 0 7.472 217.871 797.499 Tm
0.0001 Tc
[(LIMIT)66.5(A)103.5(TIONS)-340.7(OF)-330.8(THE)-342.5(EMBOLIC)-337.5(HYPOTHE)-11.1(SIS)]TJ
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[(Do)-335.5(recurr)11.3(ent)-339.2(episode)-8.1(s)-332(o)0(f)-338.9(major)-338.2(pulmona)-7.7(ry)]TJ
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[(embolism)-340.8(cau)-7.6(se)-333.2(chronic)-331.7(pulmona)-7.7(ry)-337.7(hypertensi)-11.6(on?)]TJ
/F4 1 Tf
0.404 -1.7527 TD
[(Re)16.1(cu)15.1(rr)18(en)20.8(t)-236.5(P)11.4(E)-238.2(i)0(s)-221.3(a)-234.5(fr)18(eq)15.1(ue)15.1(nt)-220.2(ca)14.7(us)20(e)-234.5(o)0(f)-225.1(d)0(e)15.1(a)0(t)18.4(h)-234.1(in)-225.8(pe)15.1(op)21.2(le)-226.2(wi)14.9(th)]TJ
-1.0015 -1.0471 TD
[(pr)19.6(e-)13.5(ex)20.8(is)17.7(ti)16.5(ng)-240.5(se)13.9(ve)20.8(re)-242.5(ca)14.7(rd)19.6(io)13.2(va)20.8(sc)19.6(ul)13.2(ar)-242.5(im)15.7(pa)20.8(ir)17.3(me)17.7(nt)13.2(.)-250.8(P)11.4(E)-249.6(i)0(s)-244.1(n)0(o)15.5(t)0(o)18.9(-)]TJ
0 -1.0528 TD
[(ri)17.3(ou)15.5(sl)17.7(y)-330.8(d)0(i)18.9(f)20.4(fi)17.3(cu)15.1(lt)-325(to)-322.6(di)18.9(ag)15.1(no)21.2(se)13.9(,)-330.4(a)0(n)20.8(d)-336.5(re)19.2(cu)15.1(rr)18(en)20.8(t)-333.2(P)0(E)-323.5(e)0(v)15.1(e)0(n)-320.6(m)0(o)18.1(r)0(e)]TJ
0 -1.0471 TD
[(so)20(.)-324.7(M)0(o)19.3(s)0(t)-312.4(p)0(a)15.1(t)0(i)16.5(e)0(n)20.8(t)0(s)-318.1(w)12.4(it)16.5(h)-325.1(s)0(e)19.6(v)0(e)15.1(r)0(e)-310.8(C)0(T)18.1(E)0(P)17.9(H)-323.4(ha)15.1(ve)-314.9(ep)20.8(is)17.7(od)15.5(ic)-311.6(dy)15.5(s-)]TJ
0 -1.0527 TD
[(pn)15.5(oe)20.8(a,)-234.9(an)15.1(d)-245.5(t)0(h)18.9(i)0(s)-238.4(o)0(f)19.6(t)0(e)12.8(n)-245.5(ra)19.2(is)17.7(es)-236.4(th)18.9(e)-245.9(p)0(o)15.5(s)0(s)18.9(i)0(b)18.9(i)0(l)16.5(i)0(t)16.5(y)-245.5(of)-236.4(PE)17.9(.)-245.1(H)0(o)17.3(w)0(e)16.9(v)0(e)15.1(r)]TJ
T*
[(wh)17.3(en)-332(su)20(ch)-332(pa)20.8(ti)16.5(en)15.1(ts)-329.5(ha)20.8(ve)-332(pr)13.9(ev)20.8(io)18.9(us)14.4(ly)-328.3(ha)15.1(d)-336.5(l)0(u)18.9(n)0(g)-331.6(s)0(c)19.6(a)0(n)15.1(s)-337.7(th)18.9(er)13.5(e)]TJ
0 -1.0471 TD
[(ar)19.2(e)-240.2(u)0(s)20(u)0(a)15.1(l)0(l)22.2(y)-239.8(no)-223.5(sc)13.9(in)18.9(ti)16.5(gr)19.6(ap)15.1(hi)18.9(c)-234.5(c)0(h)15.1(a)0(n)20.8(g)0(e)15.1(s)-235.3(to)-225.8(su)20(pp)15.5(or)19.6(t)-236.5(a)-234.5(di)13.2(ag)20.8(no)15.5(si)17.7(s)]TJ
0 -1.0527 TD
[(of)-316.1(re)19.2(cu)15.1(rr)18(en)15.1(ce)-315.3([4)19.6(6].)]TJ
1.0015 -1.0471 TD
[(A)-539.6(l)0(i)16.5(t)0(e)18.4(r)0(a)19.2(t)0(u)18.9(r)0(e)-532.8(s)0(e)19.6(a)0(r)19.2(c)0(h)-531.2(o)0(f)-526.7(M)0(E)15.2(D)0(L)18.9(I)0(N)15.7(E)-539.8(an)20.8(d)-541.4(E)12.2(MB)14.6(AS)18.1(E)-539.8(i)0(n)]TJ
-1.0015 -1.0527 TD
[(F)11.4(e)0(b)15.1(r)0(u)19.6(a)0(r)13.5(y)-347.9(19)15.5(99)-337.3(us)14.4(in)18.9(g)-347.9(t)0(h)13.2(e)-348.3(su)20(bj)13.2(ec)20.4(t)-350.3(h)0(e)15.1(a)0(d)20.8(i)0(n)13.2(g)0(s)-338.5(")0(t)15.9(h)0(r)19.6(o)0(m)18.1(b)0(o)15.5(p)0(h)15.5(l)0(e)18.4(-)]TJ
0 -1.0471 TD
[(bi)18.9(ti)16.5(s")-318.7(an)20.8(d)-325.1(")0(P)19.1(E)0(")14.2(,)-319.1(an)15.1(d)-325.1(t)0(h)18.9(e)-325.5(te)18.4(xt)-316.9(wo)17.3(rd)19.6(s)-326.3(")0(r)16.7(e)0(c)14.7(u)0(r)19.6(r)0(e)19.2(n)0(t)18.9(")-328.1(or)-316.1("r)16.7(ec)20.4(ur)25.3(-)]TJ
0 -1.0527 TD
[(re)19.2(nc)15.1(e")17.9(,)-518.2(a)0(n)20.8(d)-518.6("P)19.1(H")-509.2(fa)13.5(il)16.5(ed)-508.4(t)13.9(o)-518.6(re)13.5(ve)20.8(al)-510.8(an)20.8(y)-518.6(c)0(a)14.7(s)0(e)19.6(s)-519.8(in)-504.7(wh)17.3(ic)12.8(h)]TJ
0 -1.0471 TD
[(ob)15.5(je)18.4(ct)18.4(iv)18.9(el)18.5(y)-217(d)0(i)18.9(a)0(g)15.1(n)0(o)15.5(s)0(e)19.6(d)-217(re)19.2(cu)15.1(rr)18(en)20.8(t)-219.4(d)0(e)15.1(e)0(p)-206.8(v)0(e)20.8(n)0(o)15.5(u)0(s)-207.6(t)0(h)18.9(r)0(o)19.6(m)0(b)12.4(o)0(s)20(i)0(s)-210(o)0(r)]TJ
0 -1.0527 TD
[(P)11.4(E)-408.9(re)13.5(su)20(lt)16.5(ed)-400.3(in)-396.6(la)12.8(t)13.9(e)0(r)-401.9(c)0(h)15.1(r)0(o)19.6(n)0(i)18.9(c)-410.9(P)11.4(H)0(,)-403.4(e)0(x)20.8(c)0(e)14.7(p)0(t)-396.6(i)0(n)-402.2(p)0(a)20.8(t)0(i)16.5(e)0(n)15.1(t)0(s)-397.7(w)0(i)14.9(t)0(h)]TJ
0 -1.0471 TD
[(an)15.1(ti)22.2(ph)15.5(os)20(ph)15.5(ol)18.9(ip)18.9(id)-425(an)15.1(ti)16.5(bo)21.2(di)13.2(es)19.6(,)-432.9(o)0(r)-424.2(o)0(t)18.9(h)0(e)15.1(r)-434.8(di)18.9(se)19.6(as)13.9(es)-424.2(kn)15.5(ow)17.3(n)-433.3(t)0(o)]TJ
0 -1.0527 TD
[(le)18.4(ad)-434.4(to)-436.4(PH)-437.2(in)18.9(de)15.1(pe)15.1(nd)21.2(en)15.1(tl)16.5(y)-444.6(o)0(f)-435.6(v)0(e)20.8(n)0(o)15.5(u)0(s)-435.2(t)0(h)18.9(r)0(o)19.6(m)0(b)12.4(o)0(e)20.8(m)0(b)18.1(o)0(l)13.2(i)0(s)17.7(m)0(.)]TJ
0 -1.0471 TD
[(Ho)17.3(we)16.9(ve)15.1(r)43.2(,)-307.7(it)-302.2(w)12.4(a)0(s)-299(c)0(o)15.1(m)0(m)14.9(o)0(n)-297.4(f)0(o)19.6(r)-309.7(au)15.1(t)13.9(h)0(o)15.5(r)0(s)-300.2(t)0(o)-299.8(a)0(s)19.6(s)0(u)20(m)0(e)-301(t)0(h)18.9(a)0(t)-300.2(o)0(b)15.5(s)0(-)]TJ
0 -1.0527 TD
[(er)19.2(ve)15.1(d)-342.2(p)0(u)21.2(l)0(m)15.7(o)0(n)15.5(a)0(r)19.2(y)-342.2(ar)19.2(te)18.4(ry)-333.2(oc)20.8(cl)12.8(us)20(io)18.9(ns)-332.8(we)16.9(re)-333.6(th)18.9(e)-342.6(r)0(e)19.2(s)0(u)20(l)0(t)-330.7(o)0(f)-333.2(u)0(n)15.5(-)]TJ
0 -1.0471 TD
[(do)15.5(cu)20.8(me)17.7(nt)13.2(ed)-593.8(pr)13.9(ev)20.8(io)18.9(us)-600.2(si)17.7(le)18.4(nt)-595.7(ve)15.1(no)21.2(us)-600.2(th)18.9(ro)19.6(mb)12.4(oe)20.8(mb)18.1(ol)13.2(is)17.7(m.)]TJ
0 -1.0527 TD
[(Ab)17.3(se)19.6(nc)15.1(e)-245.9(o)0(f)-230.7(p)0(r)13.9(o)0(o)21.2(f)-247.1(is)-232.7(no)21.2(t)-247.8(p)0(r)19.6(o)0(o)15.5(f)-241.4(of)-236.4(ab)20.8(se)13.9(nc)20.8(e,)-234.9(bu)15.5(t)-242.1(t)0(h)18.9(i)0(s)-232.7(n)0(e)15.1(g)0(a)20.8(t)0(i)16.5(v)0(e)]TJ
0 -1.0471 TD
[(re)19.2(su)14.4(lt)-279.4(at)-283.1(l)13.9(e)0(a)14.7(s)0(t)-278.2(s)0(e)13.9(r)0(v)19.6(e)0(s)-282(t)0(o)-277.1(e)0(m)12(p)0(h)21.2(a)0(s)13.9(i)0(z)18.4(e)-285.7(th)13.2(e)-285.7(r)0(a)13.5(r)0(i)17.3(t)0(y)-277.1(o)0(f)-282(t)0(h)18.9(i)0(s)-283.9(s)0(e)19.6(q)0(u)15.5(e)0(-)]TJ
0 -1.0527 TD
[(nc)15.1(e)-507.6(o)0(f)-503.9(e)0(v)20.8(e)0(n)15.1(t)0(s)17.7(.)-512.5(N)12.4(e)0(v)15.1(e)0(r)19.2(t)0(h)13.2(e)0(l)18.4(e)0(s)19.6(s)0(,)-503.1(f)0(r)18(o)0(m)-505.4(g)0(e)20.8(n)0(e)15.1(r)0(a)19.2(l)-509.6(re)13.5(ad)20.8(in)13.2(g,)-496.2(th)13.2(e)]TJ
0 -1.0471 TD
[(au)15.1(th)18.9(or)19.6(s)-394.6(a)0(r)19.2(e)-393.8(aw)16.9(ar)19.2(e)-393.8(o)0(f)-384.4(s)0(i)17.7(x)-393.4(ca)20.4(se)19.6(s)-394.6(o)0(f)-384.4(r)0(e)19.2(c)0(u)15.1(r)0(r)18(e)0(n)20.8(t)-395.8(de)20.8(ep)-383.2(ve)15.1(no)15.5(us)]TJ
0 -1.0527 TD
[(th)18.9(ro)13.9(mb)18.1(os)20(is)-210(w)12.4(h)0(i)13.2(c)0(h)-206.8(o)0(c)20.8(c)0(u)15.1(r)0(r)18(e)0(d)-206.8(i)0(n)-208.8(p)0(a)20.8(t)0(i)16.5(e)0(n)15.1(t)0(s)-204.3(w)0(h)17.3(o)-217(la)18.4(te)18.4(r)-218.6(d)0(e)20.8(v)0(e)15.1(l)0(o)18.9(p)0(e)15.1(d)]TJ
0 -1.0471 TD
[(P)11.4(H)-636.4(wh)17.3(ic)18.4(h)-638.1(t)13.9(he)15.1(se)-623.4(li)16.5(te)18.4(ra)13.5(tu)18.9(re)-623.8(se)19.6(ar)13.5(ch)20.8(es)-629.1(di)18.9(d)-632.4(n)0(o)21.2(t)-634.8(di)18.9(sc)13.9(ov)21.2(er)64.8(.)]TJ
0 -1.0527 TD
[(Cu)16.5(ri)17.3(ou)15.5(sl)17.7(y)73.2(,)-376(al)18.5(l)-378.7(s)0(i)17.7(x)-382(ca)20.4(se)19.6(s)-383.2(i)13.9(nv)15.5(ol)18.9(ve)15.1(d)-376.3(u)0(p)15.5(p)0(e)20.8(r)-377.9(li)16.5(mb)-368.9(th)13.2(ro)19.6(mb)18.1(os)14.4(is)17.7(,)]TJ
0 -1.0471 TD
[(wh)17.3(ic)18.4(h)-239.8(i)0(s)-227(r)0(e)19.2(l)0(a)18.4(t)0(i)16.5(v)0(e)15.1(l)0(y)-225.8(r)0(a)13.5(r)0(e)-225.5([)0(4)19.6(7\26152].)-244.8(The)-245.8(author)-9(s)-246.7(are)-249.4(unable)-252.5(to)]TJ
0 -1.0528 TD
[(account)-339(for)-341.2(this)-333.4(ap)-7.6(parent)-339.4(associati)-11.9(on.)]TJ
1.0015 -1.0471 TD
[(It)-324.2(is)-329.5(vi)18.9(rt)17.3(ua)20.8(ll)16.5(y)-336.5(i)0(m)15.7(p)0(o)21.2(s)0(s)13.2(i)13.9(bl)13.2(e)-331.2(t)0(o)-328.3(i)0(n)18.9(d)0(u)21.2(c)0(e)-326.7(C)0(T)12.4(E)12.2(PH)-329(in)-322.6(do)15.5(gs)-321.4(by)]TJ
-1.0015 -1.0528 TD
[(me)17.7(an)15.1(s)-326.3(o)0(f)-310.4(r)0(e)13.5(p)0(e)20.8(a)0(t)12.8(e)0(d)-314.9(e)0(m)17.7(b)0(o)15.5(l)13.9(is)12(m)-322.6(o)0(f)-316.1(t)0(h)18.9(r)0(o)13.9(m)0(b)18.1(o)0(t)18.9(i)0(c)-317.3(m)0(a)17.7(t)0(e)18.4(r)0(i)17.3(a)0(l)-317.3([)0(5)13.9(3].)]TJ
0 -1.0471 TD
[(However)18.5(,)-284.9(occlusion)-292.5(of)]TJ
/F9 1 Tf
9.3553 0 TD
0 Tw
($)Tj
/F4 1 Tf
0.8308 0 TD
[(80%)-289.2(of)-287.7(the)-289.6(pu)-7.2(lmonary)-291.7(vascul)-9(ar)]TJ
-10.1861 -1.0528 TD
[(bed)-327.1(with)-324.7(inert)-329.2(mat)-8.2(erials)-325.9(such)-329(as)-321.8(lead,)-331(may)-324.5(induce)-332.1(PH)-323.3(in)]TJ
0 -1.0471 TD
[(the)-528.6(anim)-9(als)-529.8(that)-531.7(survi)-9(ve)-525.5([54].)-535.8(When)-533.8(the)-528.6(contr)-8.2(alateral)]TJ
0 -1.0527 TD
[(pulmo)-9.3(nary)-460.3(arter)-10.2(y)-456(was)-463.1(liga)-8.2(ted,)-460.7(and)-463.6(autologous)-469.2(thrombi)]TJ
0 -1.0471 TD
[(were)-259.8(subseq)-7.4(uentl)-9(y)-251.2(embol)-9.7(ized,)-262.7(more)-258.6(signifi)-9.6(cant)-256.6(ac)-8(ute)-255.5(ele-)]TJ
0 -1.0527 TD
[(vation)-9.7(s)-417.4(o)0(f)-418.5(pulmonary)-424.1(a)-6.9(rtery)-419.5(press)-8.2(ure)-419.7(were)-424.8(observ)-7.8(ed)-417.3(in)]TJ
0 -1.0471 TD
[(dogs.)-311.9(However)18.5(,)-302(i)0(t)-313.6(was)-309.4(still)-316.1(not)-306.3(possi)-8.6(ble)-306.7(to)-311.2(cause)-313.5(chroni)-9(c)]TJ
0 -1.0528 TD
[(PH)-243.7(by)-246.2(repeat)-9.8(ed)-246.6(injections)-252.5(over)-249.7(a)-240.2(perio)-8.2(d)-245.5(o)0(f)-242.1(4)-245.5(months)-250.3([55].)]TJ
T*
[(However)18.5(,)-302(i)0(n)-305.5(dogs)-305.8(treat)-11(ed)-303.5(with)-307.7(trane)-8.6(xamic)-311.7(acid)-307.8(to)-305.5(inhibit)]TJ
0 -1.0471 TD
[(fibrinol)-10.7(ysis,)-400.8(inje)-8.2(cted)-398.9(autol)-9(ogous)-403.3(venous)-404.5(thrombi)-407.5(persist)]TJ
0 -1.0528 TD
[(in)-208.8(the)-215.6(pulmonary)-219.2(circulatio)-14.3(n)-205.6(for)-216(up)-206.4(to)-214.5(one)-207.6(yr)25.3(,)-205.2(and)-213.2(repeat)-9.8(ed)]TJ
0 -1.0471 TD
[(injectio)-10.7(ns)-435.2(of)-435.6(this)-435.8(material)-446(may)-438.3(elevate)-438.5(the)-437.6(resting)-440.1(pul-)]TJ
0 -1.0528 TD
[(monar)-9(y)-370.7(artery)-380.8(pressure)-376.7(to)-373.8(a)-376.7(level)-373.6(of)-373(~35)-375.3(mm)-7.8(Hg)-369.7(ov)-7.2(er)-373.4(a)]TJ
0 -1.0471 TD
[(perio)-8.2(d)-330.8(o)0(f)-338.9(3)0(0)-331.6(days)-340.4([56].)]TJ
1.0015 -1.0527 TD
[(It)-477.8(is)-477.4(co)20.8(nc)15.1(lu)18.9(de)15.1(d)-484.5(t)0(h)18.9(a)0(t)-476.6(r)0(e)19.2(c)0(u)15.1(r)0(r)18(e)0(n)15.1(t)-486.8(m)13.2(a)0(j)12.8(o)0(r)-475.4(P)11.4(E)-488.6(c)0(o)20.8(u)0(l)13.2(d)-484.5(ca)20.4(us)14.4(e)]TJ
-1.0015 -1.0471 TD
[(ch)15.1(ro)19.6(ni)18.9(c)-342.6(P)0(H)-340.4(i)0(n)-334(s)0(o)20(m)0(e)-340.8(i)0(n)18.9(d)0(i)18.9(v)0(i)18.9(d)0(u)15.5(a)0(l)18.4(s)-343.4(if)-335.6(th)18.9(e)-348.3(c)0(u)20.8(m)0(u)12.4(l)0(a)18.4(t)0(i)16.5(v)0(e)-332(t)0(h)18.9(r)0(o)13.9(m)0(-)]TJ
0 -1.0527 TD
[(bo)15.5(ti)22.2(c)-280(l)0(o)18.9(a)0(d)-269.4(w)12.4(er)13.5(e)-274.3(s)0(u)20(f)14.7(fi)17.3(ci)18.5(en)20.8(t)-276.3(a)0(n)15.1(d)-273.9(if)-267.3(th)13.2(e)-274.3(e)0(p)20.8(i)0(s)17.7(o)0(d)15.5(e)0(s)-264.9(w)0(e)16.9(r)0(e)-271(c)0(l)18.5(o)0(s)20(e)0(l)12.8(y)]TJ
0 -1.0471 TD
[(sp)20(ac)14.7(ed)15.1(.)-455.6(H)0(o)17.3(w)0(e)16.9(v)0(e)15.1(r)43.2(,)-461.3(i)0(n)-453.5(t)0(h)18.9(i)0(s)-449(s)0(i)17.7(t)0(u)13.2(a)0(t)18.4(i)0(o)18.9(n)-461.7(su)20(rv)19.6(iv)13.2(al)-448.2(is)-454.7(re)19.2(la)18.4(ti)16.5(ve)15.1(ly)]TJ
0 -1.0527 TD
[(un)15.5(li)22.2(ke)15.1(ly)81.4(.)-410.1(C)0(o)16.5(n)0(s)20(e)0(q)15.1(u)0(e)20.8(n)0(t)13.2(l)0(y)-396.6(t)0(h)13.2(i)13.9(s)-411.7(i)0(s)-403.4(u)0(n)21.2(l)0(i)16.5(k)0(e)15.1(l)13.9(y)-410.5(t)0(o)-402.2(b)0(e)-400.3(a)-410.9(co)20.8(mm)14.9(on)]TJ
0 -1.0471 TD
[(ca)14.7(us)20(e)-325.5(o)0(f)-316.1(C)11.6(TE)13(P)11.4(H)0(.)]TJ
/F7 1 Tf
2.077 -2.9136 TD
[(Does)-338.6("miliary)-345.3(pulmona)-7.7(ry)-337.7(embolism)-10.7(")-335.7(cause)]TJ
3.8013 -1.0471 TD
[(pulmona)-7.7(ry)-337.7(hype)-7.6(rtension?)]TJ
/F4 1 Tf
-4.8768 -1.6503 TD
[("M)16.3(il)16.5(ia)18.4(ry)-287.7(PE)12.2(")-293.9(r)0(e)13.5(f)0(e)19.2(r)0(s)-288.8(t)0(o)-294.1(t)0(h)18.9(e)-297.1(pa)15.1(ss)18.9(ag)20.8(e)-302.8(t)0(o)-288.4(t)0(h)18.9(e)-302.8(l)13.9(u)0(n)15.5(g)0(s)-287.2(o)0(f)-293.3(l)0(a)18.4(r)20.4(ge)]TJ
-1.0015 -1.0528 TD
[(am)17.7(ou)15.5(nt)18.9(s)-320.6(o)0(f)-310.4(m)0(a)17.7(t)0(e)18.4(r)0(i)17.3(a)0(l)-311.6(w)0(h)17.3(i)0(c)18.4(h)-319.4(is)-306.7(mo)12.4(st)17.7(ly)-305.5(no)15.5(t)-316.1(m)0(a)12(c)0(r)19.2(o)0(s)20(c)0(o)15.1(p)0(i)18.9(c)0(a)14.7(l)0(l)16.5(y)]TJ
0 -1.0471 TD
[(vi)18.9(si)17.7(bl)18.9(e.)-428.3(N)12.4(o)0(n)15.5(t)0(h)18.9(r)0(o)13.9(m)0(b)18.1(o)0(t)18.9(i)0(c)-425.4(m)0(i)15.7(l)0(i)16.5(a)0(r)19.2(y)-433.3(P)11.4(E)-437.4(as)-424.2(a)-433.7(r)0(e)19.2(s)0(u)20(l)0(t)-427.4(o)0(f)-424.2(S)11.4(ch)15.1(is)17.7(-)]TJ
0 -1.0528 TD
[(to)18.9(so)14.4(mi)15.7(as)19.6(is)-272.6(an)15.1(d)-285.3(D)12.4(il)16.5(of)13.9(il)16.5(ar)19.2(ia)18.4(si)17.7(s)-286.5(i)0(s)-272.6(b)0(e)15.1(l)0(i)16.5(e)0(v)20.8(e)0(d)-275.1(t)0(o)-277.1(a)0(f)30.6(f)0(e)13.5(c)0(t)-271.8(m)0(i)15.7(l)0(l)16.5(i)0(o)18.9(n)0(s)14.4(,)]TJ
0 -1.0471 TD
[(pa)15.1(rt)17.3(ic)18.4(ul)18.9(ar)19.2(ly)-277.1(i)13.9(n)-285.3(th)18.9(ir)17.3(d)-279.6(w)0(o)17.3(r)0(l)17.3(d)-279.6(co)15.1(un)15.5(t)13.9(r)0(i)11.6(e)0(s)19.6(.)-279.2(Ho)17.3(we)16.9(ve)15.1(r)43.2(,)-284.9(in)-271.4(ad)20.8(di)18.9(ti)16.5(on)]TJ
0 -1.0528 TD
[(to)-373.8(oc)20.8(cl)18.5(ud)15.5(in)18.9(g)-382(t)0(h)18.9(e)-382.4(mi)15.7(cr)19.2(ov)15.5(as)19.6(cu)15.1(la)18.4(tu)18.9(re)-373.4(of)-373(th)18.9(e)-382.4(l)0(u)18.9(n)0(g)21.2(s)0(,)-372.2(b)0(o)15.5(t)0(h)-368.1(t)0(h)13.2(e)]TJ
0 -1.0471 TD
[(eg)15.1(gs)-275.9(of)]TJ
/F5 1 Tf
3.181 0 TD
[(Sc)20.8(hi)13.2(st)17.7(os)20(om)17.3(a)-285.3(m)0(a)17.3(n)0(s)20(o)0(n)15.5(i)]TJ
/F4 1 Tf
8.7691 0 TD
[(an)20.8(d)-285.3(f)0(i)17.3(l)0(a)18.4(r)0(i)11.6(a)0(l)-271.8(w)0(o)11.6(r)0(m)16.5(s)-280.8(ca)14.7(us)20(e)-285.7(a)0(n)]TJ
13.2476 66.1583 TD
[(in)13.2(te)18.4(ns)20(e)-496.2(i)0(n)18.9(f)0(l)17.3(a)0(m)12(m)0(a)17.7(t)0(o)18.9(r)0(y)-486.8(r)0(e)13.5(a)0(c)20.4(t)0(i)16.5(o)0(n)-485.2(w)0(i)14.9(t)0(h)-487.6(f)0(i)17.3(b)0(r)19.6(o)0(s)14.3(i)0(s)-483.1(o)0(f)-492.5(t)13.9(he)-491.3(pu)21.2(l-)]TJ
0 -1.0471 TD
[(mo)12.4(na)20.8(ry)-333.2(ar)19.2(te)18.4(ri)17.3(ol)13.2(es)-327.5([5)13.9(7].)-339.2(A)-351.8(simila)-10.8(r)-349.5(vascular)-353.9(react)-9(ion,)-352.2(with)]TJ
0 -1.0528 TD
[(granul)-9(omat)-9(ous)-612.4(arter)-10.2(itis)-614.6(resul)-9.4(ting)-616.7(in)-618.5(PH,)-613.9(is)-614(de)-7.6(scribed)]TJ
0 -1.0471 TD
[(foll)-9.4(owing)-385.7(the)-392(intravenous)-392.3(inje)-8.2(ction)-390.3(of)-384.4(crushe)-8.2(d)-382(pentaz)-8.2(o-)]TJ
0 -1.0528 TD
[(cine)-433(table)-9.4(ts)-426.2(intended)-432.8(for)-432.3(oral)-428.5(u)-6.5(s)0(e)-424.2([58].)-433.4(Miliary)-437.5(tumour)]TJ
0 -1.0471 TD
[(embol)-9.7(i)-225.1(are)-226.6(anothe)-7.8(r)-224.3(relat)-11(ively)-225.2(comm)-9.7(on)-223.5(cause)-233.8(of)-225.1(right)-226.4(he)-7.6(art)]TJ
0 -1.0528 TD
[(fail)-9.8(ure,)-312(since)-321.2(2%)-311.2(of)-316.1(patients)-322.5(dying)-313.5(of)-316.1(breast)-317.8(cancer)-320.8(have)]TJ
0 -1.0471 TD
[(these)-605.7(findings)-605.5([59,)-601.8(60].)-601.8(Lac)-7.2(king)-597.2(speci)-8.2(fic)-604.2(fibrinol)-10.7(ytic)]TJ
0 -1.0527 TD
[(mecha)-8.2(nism)-9.8(s)-280.8(o)0(f)-282(remo)-8.2(val,)-284.3(tumour)-290.5(emboli)-286(general)-10.5(ly)-282.8(persi)-9.4(st)]TJ
T*
[(longer)-316.2(in)-311.2(the)-306.7(pulm)-8.6(onary)-307.4(c)-6.9(irculation)-315.5(than)-313.1(thrombot)-9.9(ic)-305.9(em-)]TJ
0 -1.0471 TD
[(boli)-485.8([61].)-484.6(L)52(ycopodi)-8.1(um)-477(spores)-487(have)-481.9(been)-481.9(inje)-8.2(cted)-484.3(into)]TJ
0 -1.0528 TD
[(severa)-8.6(l)-475.5(anim)-9(al)-476.6(species)-477.9(and)-480.7(these)-474.8(jagged)-480.1(o)-6.5(bjects)-478(cause)]TJ
0 -1.0471 TD
[(more)-389.5(endoth)-7.4(elial)-381.7(damag)-7.8(e)-382.4(and)-384(greater)-387.7(elevat)-10.5(ions)-382.2(of)-378.7(pul-)]TJ
0 -1.0527 TD
[(monar)-9(y)-404.8(arter)-10.2(y)-404.8(press)-8.2(ure)-408.3(than)-409.9(similar)-411.5(sized)-412.2(smoo)-7.4(th)-407.9(latex)]TJ
0 -1.0471 TD
[(mic)-8.2(rosphe)-7.8(res)-335.5([62].)]TJ
1.0015 -1.0527 TD
[(Wh)14.4(en)-235.2(in)13.2(di)18.9(vi)18.9(du)15.5(al)18.5(s)-246.7(w)12.4(it)16.5(h)-245.5(P)0(H)-238(a)0(n)15.1(d)-245.5(ri)17.3(gh)15.5(t)-242.1(h)0(e)15.1(a)0(r)19.2(t)-247.8(fa)19.2(il)16.5(ur)19.6(e)-245.9(d)0(o)-240.5(n)0(o)21.2(t)]TJ
-1.0015 -1.0471 TD
[(ha)15.1(ve)-491.3(an)20.8(y)-501.5(v)0(i)18.9(s)0(i)17.7(b)0(l)18.9(e)-501.9(ev)20.8(id)13.2(en)20.8(ce)-491.7(of)-492.5(de)20.8(ep)-491.3(ve)15.1(no)21.2(us)-492.1(th)18.9(ro)19.6(mb)12.4(os)20(is)17.7(,)]TJ
0 -1.0528 TD
[("m)15.1(il)16.5(ia)18.4(ry)-412.8(P)11.4(E)0(")-412.6(h)0(a)20.8(s)-417.4(fr)12.4(eq)20.8(ue)15.1(nt)18.9(ly)-407.9(be)15.1(en)-406(in)13.2(vo)21.2(ke)15.1(d)-416.2(a)0(s)-412.8(a)-416.6(po)15.5(ss)18.8(ib)18.9(le)]TJ
0 -1.0471 TD
[(ca)14.7(us)20(e,)-382.8(bu)15.5(t)-390.1(t)0(h)18.8(i)0(s)-380.7(i)0(s)-386.4(c)0(o)20.8(n)0(s)20(i)0(d)13.2(e)0(r)19.2(e)0(d)-383.2(b)0(y)-382.8(s)0(o)20(m)0(e)-380.7(t)0(o)-385.2(b)0(e)-383.2(b)0(i)18.9(o)0(l)18.9(o)0(g)15.5(i)0(c)18.5(a)0(l)18.4(l)0(y)]TJ
0 -1.0527 TD
[(im)15.7(pl)13.2(au)20.8(si)17.7(bl)18.8(e)-587.3([)0(6)13.9(3].)-589.6(When)-602.1(miliary)-603.8(embol)-9.7(i)-595(consi)-7.8(sting)-601.6(of)]TJ
0 -1.0471 TD
[(bland)-393.6(substan)-10.5(ces)-385.6(find)-394(their)-391.8(way)-387.9(into)-389.1(the)-392(lungs,)-389(advers)-8.2(e)]TJ
0 -1.0528 TD
[(effects)-240.9(are)-238(extre)-8.6(mely)-242.3(rare.)-246.4(For)-236.4(examp)-7.8(le,)-243.7(when)-240.7(a)-240.2(lung)-238.7(scan)]TJ
0 -1.0471 TD
[(is)-335.2(perfor)-9.8(med,)-336.3(radio)-8.2(labelled)-338.8(parti)-10.6(cles)-331.8(of)-338.9(albumin)-338(or)-333.2(other)]TJ
0 -1.0527 TD
[(mic)-8.2(rosphe)-7.8(res)-255.9(of)-253.5(between)-257.6(8\26150)]TJ
/F8 1 Tf
12.4225 0 TD
(m)Tj
/F4 1 Tf
0.5747 0 TD
[(m)-254.3(i)0(n)-254.3(size)-257.8(are)-255.1(injected,)-259.5(so)]TJ
-12.9972 -1.0471 TD
[(as)-447(to)-447.8(occlud)-7.8(e)-439.3(b)0(e)-7.6(tween)-449.1(1\2615%)-449.3(of)-441.3(the)-448.9(pulmonary)-452.6(vascu-)]TJ
0 -1.0528 TD
[(latu)-8.2(re.)-459.2(The)-6.8(se)-458.4(particles)-467.6(are)-459.9(remo)-8.2(ved)-457.9(into)-463.1(the)-460.3(lym)-7.8(phatic)]TJ
0 -1.0471 TD
[(syst)-7.8(em)-295.3(in)-288.4(the)-295.3(course)-298.4(of)-287.7(8\26124)-293.3(h.)-291.4(This)-295.3(procedu)-7.7(re)-293.7(is)-295.3(remar-)]TJ
0 -1.0527 TD
[(kab)-8.4(ly)-578.7(safe,)-581.8(in)-578.7(the)-585.5(40)-576.3(yrs)-579.8(du)-7.2(ring)-581.8(which)-585.3(it)-575.3(has)-584.3(been)]TJ
0 -1.0471 TD
[(empl)-9(oyed)-270.9(there)-276.1(ha)-7.6(ve)-269.4(been)-277(no)-269(reports)-280(of)-270.6(chroni)-9(c)-268.6(P)0(H)-272.1([64].)]TJ
0 -1.0528 TD
[(Mil)-9(iary)-212.3(thrombot)-9.9(ic)-214.9(embolis)-9.2(m)-208.8(also)-217.6(seems)-215(to)-214.5(be)-206.8(a)-211.7(relat)-11(ively)]TJ
0 -1.0471 TD
[(ben)-8.4(ign)-454.2(event.)-456.9(Prolon)-7.8(ged)-457.9(asymptom)-10.7(atic)-458.2(microem)-10.7(bolism)]TJ
0 -1.0528 TD
[(was)-537(detect)-10.6(ed)-531.2(by)-536.4(Doppler)-537.2(ultr)-9.4(asound)-535.4(in)-533.1(most)-539(patients)]TJ
0 -1.0471 TD
[(und)-8(ergoing)-339.8(hip)-351.8(or)-350.2(knee)-351(arthroplas)-11.9(ty)58.7(,)-341.8(and)-349.8(there)-355.7(were)-350.8(not)]TJ
0 -1.0527 TD
[(app)-8.4(arent)-338.7(advers)-8.2(e)-331.2(effects)-332([65].)]TJ
1.0015 -1.0471 TD
[(Up)-278.6(to)-277.1(76)-274.7(in)13.2(je)18.4(ct)18.5(io)18.9(ns)-275.9(of)-270.6(fi)17.3(ne)20.8(ly)-277.1(di)18.9(vi)18.9(de)15.1(d)-285.3(t)0(h)18.9(r)0(o)13.9(m)0(b)18.1(i)-282(we)16.9(re)-282.4(re)19.2(q-)]TJ
-1.0015 -1.0527 TD
[(ui)13.2(re)19.2(d)-205.6(t)13.9(o)-205.6(i)0(n)18.8(d)0(u)15.5(c)0(e)-195.8(e)0(v)20.8(e)0(n)-195.4(m)0(i)15.7(l)0(d)-191.7(P)0(H)-198.2(i)0(n)-191.7(r)0(a)13.5(b)0(b)21.2(i)0(t)16.5(s)0(,)-195.8(a)0(n)20.8(d)-205.6(se)19.6(ve)15.1(re)-197(P)11.4(H)-203.9(wa)16.9(s)]TJ
0 -1.0471 TD
[(no)15.5(t)-310.4(o)0(b)15.5(s)0(e)19.6(r)0(v)19.6(e)0(d)-303.5([)0(6)13.9(6].)-310.8(Persi)-8.6(sting)-322.7(PH)-323.4(could)-325.3(also)-325.7(not)-323.3(be)-320.6(indu-)]TJ
0 -1.0528 TD
[(ced)-304.7(in)-305.5(dogs)-305.8(despi)-7.8(te)-300.2(inje)-8.2(ction)-304.9(of)-304.7(up)-303.1(to)-305.5(15)-303.1(g)-302.4(o)0(f)-304.7(copolymer)]TJ
0 -1.0471 TD
[(granul)-9(es,)-174.2(35\261300)-169.6(mm)-178.5(in)-168.9(size,)-172.8(over)-175.8(a)-166.2(perio)-8.2(d)-171.5(o)0(f)-168.2(mont)-8.6(hs)-167.7([67].)]TJ
/F7 1 Tf
1.8324 -2.5607 TD
[(Chronic)-335.2(pulmona)-7.7(ry)-337.7(hypertensi)-11.6(on)-330.8(in)-338.9(anima)-7.8(ls)]TJ
/F4 1 Tf
-0.8308 -1.6503 TD
[(Ch)16.5(ro)13.9(ni)18.9(c)-251.6(P)11.4(H)-255.1(i)0(s)-238.4(o)0(b)15.5(s)0(e)19.6(r)0(v)13.9(e)0(d)-240.9(i)0(n)-237.2(m)0(a)12(n)0(y)-240.5(a)0(n)20.8(i)0(m)15.7(a)0(l)-243.3(s)0(p)20(e)0(c)14.7(i)0(e)18.5(s)0(.)-241.3(E)0(x)17.1(a)0(m)17.7(-)]TJ
-1.0015 -1.0528 TD
[(pl)13.2(es)-196.6(in)13.2(cl)18.5(ud)21.2(e)-211.7(r)0(a)19.2(t)0(s)-204.3([)0(6)19.6(8],)-208.4(poult)-8.6(ry)-219.4([69,)-220.5(70],)-226.2(cattle)-223.5([71,)-220.5(72],)-220.5(pigs)]TJ
0 -1.0471 TD
[([73])-387.5(and)-378.3(horses)-390.2([74].)-382.2(Many)-386.7(stimuli)-383.4(that)-383.8(provoke)-388.6(PH)-380.3(in)]TJ
0 -1.0527 TD
[(man,)-233.8(such)-232.3(as)-230.7(altitud)-9.6(e,)-229.2(hypoxi)-7(a,)-229.2(parasiti)-11.1(c)-228.8(infection)-10.7(s,)-230(patent)]TJ
0 -1.0471 TD
[(duc)-8.4(tus)-267.6(arter)-10.2(iosus,)-276.4(endotoxins)-8.3(,)-267.8(anorexi)-10.1(ent)-272.5(and)-270.1(other)-275.7(drugs)]TJ
0 -1.0528 TD
[(hav)-8.4(e)-428(also)-433.8(been)-430.7(show)-8.2(n)-427.6(t)0(o)-430.7(provoke)-439.8(similar)-434.2(respon)-7.8(ses)-431.9(in)]TJ
0 -1.0471 TD
[(severa)-8.6(l)-299.1(other)-298.4(mam)-9(malian)-303.5(species,)-301.9(sugges)-7.4(ting)-298(more)-304.1(inter-)]TJ
0 -1.0527 TD
[(speci)-8.2(es)-441.3(sim)-9(ilarities)-449.2(than)-449.7(dif)10.8(ference)-10.1(s)-440.1([75].)-450.5(The)-445(fact)-446(that)]TJ
0 -1.0471 TD
[(chroni)-9(c)-371.1(P)0(H)-368.9(was)-372(not)-368.9(provoke)-7.3(d)-370.7(b)0(y)-371.4(repeated)-375.9(injectio)-10.7(ns)-366.9(of)]TJ
0 -1.0528 TD
[(throm)-10.9(botic)-418.7(mat)-8.2(erial)-420.7(in)-419.3(an)-7.6(y)-416.2(o)0(f)-418.5(the)-420.5(animal)-423(speci)-8.2(es)-418.5(prev-)]TJ
T*
[(iousl)-9.8(y)-359.3(discu)-7.8(ssed,)-364.7(is)-363.6(indirect)-368.5(eviden)-7.8(ce)-366.5(that)-366.7(such)-363.2(a)-359.7(mech-)]TJ
0 -1.0471 TD
[(anism)-341(may)-341.6(also)-337.1(not)-334.7(be)-337.7(operative)-338.8(in)-339.7(human)-7.4(s.)]TJ
1.0015 -1.0527 TD
[(In)-577.9(co)15.1(nt)18.9(ra)19.2(st)17.7(,)-586.5(o)0(c)20.8(c)0(l)18.4(u)0(s)14.4(i)0(o)18.8(n)-586.9(of)-572.2(th)18.9(e)-587.3(p)0(u)21.2(l)0(m)15.7(o)0(n)15.5(a)0(r)19.2(y)-586.9(ar)19.2(te)18.4(ri)17.3(es)-577.9(of)]TJ
-1.0015 -1.0471 TD
[(pi)13.2(gl)18.9(et)18.4(s)-332(b)0(y)-325.9(c)0(o)15.1(i)13.9(l)-338.9(e)0(m)17.7(b)0(o)21.2(l)0(i)16.5(z)0(a)14.7(t)0(i)16.5(o)0(n)21.2(,)-336.1(pr)19.6(od)21.2(uc)15.1(ed)-326.3(a)-331.2(c)0(o)15.1(n)0(d)21.2(i)0(t)16.5(i)0(o)18.9(n)-336.5(wh)17.3(ic)18.4(h)]TJ
0 -1.0527 TD
[(ap)15.1(pe)15.1(ar)19.2(ed)-201.1(to)-203.1(be)-201.1(hi)18.9(st)17.7(ol)13.2(og)21.2(ic)18.4(al)18.5(ly)-203.1(an)15.1(d)-211.3(p)0(h)21.2(y)0(s)14.4(i)0(o)18.9(l)0(o)18.8(g)0(i)18.9(c)0(a)14.7(l)0(l)16.5(y)-211.3(ve)20.8(ry)-202.3(si)17.7(m-)]TJ
0 -1.0471 TD
[(il)16.5(ar)-310.8(to)-311.2(CT)18.1(EP)17.9(H)-323.4(i)0(n)-311.2(h)0(u)21.2(m)0(a)17.7(n)0(s)14.4(,)-319.1(bu)21.2(t)-321.8(o)0(n)21.2(l)0(y)-311.2(w)0(h)17.3(e)0(n)-309.2(t)0(i)16.5(s)0(s)18.8(u)0(e)-314.9(a)0(d)20.8(h)0(e)15.1(s)0(i)17.7(v)0(e)]TJ
0 -1.0528 TD
[(wa)16.9(s)-553.9(a)0(l)18.4(s)0(o)-543.3(a)0(p)15.1(p)0(l)18.9(i)0(e)18.4(d)-552.7(to)-544.5(th)18.9(e)-553.2(e)0(m)17.7(b)0(o)21.2(l)0(i)16.5(z)0(a)14.7(t)0(i)16.5(o)0(n)-542.1(s)0(i)17.7(t)0(e)18.4(s)0(.)-542.9(T)0(h)17.1(e)-553.2(po)21.2(st)17.7(-)]TJ
0 -1.0471 TD
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[(ed)-497(em)17.7(bo)15.5(le)18.4(ct)18.5(om)12.4(y")18.3(.)-501.2(T)0(h)17.1(r)0(o)13.9(m)0(b)18.1(e)0(n)20.8(d)0(a)15.1(r)0(t)17.3(e)0(c)14.7(t)13.9(om)12.4(y)-501.5(i)0(s)-500.2(a)-507.6(pr)19.6(oc)15.1(ed)20.8(ur)13.9(e)]TJ
0 -1.0641 TD
[(wh)17.3(ic)18.4(h)-245.5(i)13.9(s)-241(a)0(l)12.8(s)0(o)-230.3(e)0(m)17.7(p)0(l)18.9(o)0(y)15.5(e)0(d)-229.6(t)0(o)-237.2(r)0(e)19.2(m)0(o)18.1(v)0(e)-235.2(a)0(t)18.4(h)0(e)20.8(r)0(o)13.9(m)0(a)-232.7(i)0(n)-231.5(t)0(h)18.9(e)-245.9(ca)20.4(ro)13.9(t)13.9(i)0(d)13.2(,)]TJ
0 -1.0698 TD
[(fe)19.2(mo)12.4(ra)19.2(l,)-242.5(re)13.5(na)20.8(l,)-248.2(co)20.8(ro)13.9(na)20.8(ry)76.5(,)-250.8(a)0(n)15.1(d)-251.2(ot)18.9(he)15.1(r)-252.7(l)0(a)18.4(r)14.7(ge)-240.9(ar)13.5(te)18.4(ri)17.3(es)19.6(,)-256.5(h)0(o)21.2(w)0(e)11.2(v)0(e)20.8(r)37.5(,)]TJ
T*
[(in)-493.3(t)13.9(h)0(e)15.1(s)0(e)-492.5(l)0(o)18.9(c)0(a)14.7(t)13.9(io)13.2(ns)-486.4(em)12(bo)21.2(li)16.5(sm)-489.6(is)-494.5(se)19.6(ld)18.9(om)-494.1(po)15.5(st)17.7(ul)18.9(at)18.4(ed)-491.3(as)-492.5(a)]TJ
T*
[(ca)14.7(us)20(e.)-411.3(Th)17.1(e)-422.3(o)0(b)21.2(s)0(t)17.7(r)0(u)13.9(c)0(t)18.5(i)0(n)18.9(g)-421.9(le)18.4(si)17.7(on)15.5(s)-423.1(i)13.9(n)-421.9(C)0(T)12.4(E)12.2(PH)-414.4(ar)19.2(e)-422.3(n)0(o)15.5(t)-418.6(fi)17.3(br)13.9(in)]TJ
0 -1.0641 TD
[(th)18.9(ro)13.9(mb)18.1(i,)-532.7(bu)21.2(t)-543.7(i)0(n)18.9(t)0(i)16.5(m)0(a)12(l)-538.1(pl)13.2(aq)20.8(ue)15.1(s,)-531.6(to)18.9(ge)15.1(th)18.9(er)-532.7(wi)14.9(th)-533.1(ma)17.7(ss)18.9(es)-532.3(of)]TJ
0 -1.0698 TD
[(or)25.3(ga)20.8(ni)18.9(ze)14.7(d)-256.8(m)0(a)12(t)0(e)18.4(r)0(i)17.3(a)0(l)-249(w)0(h)17.3(i)0(c)12.8(h)-256.8(hi)18.9(st)17.7(ol)13.2(og)21.2(ic)18.4(al)12.8(ly)-248.6(ar)19.2(e)-262.9(v)0(e)15.1(r)0(y)-247.8(s)0(i)17.7(m)0(i)15.7(l)0(a)18.4(r)-264.1(to)]TJ
T*
[(ad)15.1(va)20.8(nc)15.1(ed)-314.9(pa)20.8(rt)17.3(ia)12.8(l)13.9(l)0(y)-316.9(r)0(e)13.5(c)0(a)20.4(n)0(a)15.1(l)0(i)16.5(z)0(e)20.4(d)-325.1(at)18.4(he)15.1(ro)19.6(ma)-318.1([1)19.6(02)15.5(].)]TJ
1.0015 -1.0471 TD
[(T)69.1(o)-467.4(da)20.8(te)-465.2(on)21.2(ly)-459.2(~1)18.1(,5)15.9(00)-456.8(pu)15.5(lm)15.7(on)21.2(ar)13.5(y)-467.4(t)0(h)18.9(r)0(o)13.9(m)13.2(be)15.1(nd)15.5(ar)19.2(te)18.4(ct)18.4(om)12.4(y)]TJ
-1.0015 -1.0698 TD
[(op)15.5(er)19.2(at)18.5(io)18.9(ns)-406.8(ha)15.1(ve)-406(be)20.8(en)-411.7(pe)20.8(rf)18(or)13.9(me)17.7(d)-416.2(w)0(o)17.3(r)0(l)17.3(d)0(w)17.3(i)0(d)18.9(e)-416.6([1)19.6(03)15.5(].)-423.8(Con)-7(-)]TJ
T*
[(sequent)-9.7(ly)-334(few)-338.3(clinicia)-11.1(ns)-332.8(outsi)-9.8(de)-332(of)-338.9(two)-338.7(or)-333.2(three)-338.6(speci)-8.2(al-)]TJ
0 -1.0641 TD
[(ized)-245.2(centr)-8.6(es)-236.4(wi)-7.8(ll)-239.6(have)-242.9(any)-247.4(significant)-249.1(person)-7.8(al)-243.3(experi)-9.4(ence)]TJ
0 -1.0698 TD
[(with)-358.9(the)-357.9(effects)-354.7(of)-355.9(the)-357.9(procedu)-7.7(re.)-356.7(The)-359.6(reader)-361.8(is)-357.9(referr)-11.8(ed)]TJ
T*
[(to)-436.4(a)-433.7(recent)-436.6(edit)-8.2(orial)-437.4(on)-434(this)-435.8(subje)-7.8(ct,)-431.5(whi)-8.6(ch)-434.4(may)-432.6(dispe)-7.8(l)]TJ
T*
[(some)-224(comm)-9.7(on)-223.5(misconcept)-12.2(ions)-222.9([103].)-229.3(The)-223.1(removal)-229.5(of)-219.4(vis-)]TJ
0 -1.0641 TD
[(ible)-469.2(thrombus)-475.3(is)-466(largely)-462.1(incidental)-473.6(to)-470.5(the)-466(operation)-475(of)]TJ
0 -1.0698 TD
[(pulmo)-9.3(nary)-266.8(thrombenda)-9.9(rtect)-11(omy)62.9(.)-267.8(I)0(n)-264.9(the)-266.8(majo)-9(rity)-265.5(of)-264.9(pati)-8.2(e-)]TJ
T*
[(nts)-381.4(no)-377.1(free)-382.6(thrombus)-384.3(is)-380.7(presen)-8.2(t)-378.7(and)-378.3(initial)-387.5(direct)-381.6(exam-)]TJ
0 -1.0641 TD
[(ination)-331.6(of)-321.8(the)-329.4(pulmonary)-333.1(vascular)-331.2(bed)-321.4(may)-330.2(appear)-326.1(to)-328.3(be)]TJ
0 -1.0698 TD
[(norm)-7.8(al.)]TJ
1.0015 -1.0527 TD
[(V)109.1(a)0(s)19.6(c)0(u)20.8(l)0(a)12.8(r)-201.5(ob)21.2(st)17.7(ru)13.9(ct)18.4(io)18.9(n)-205.6(i)0(n)-191.7(C)0(T)18.1(E)0(P)17.9(H)-203.9(is)-192.9(se)13.9(ld)18.9(om)-192.5("l)15.9(oc)20.8(al)12.8(iz)18.4(ed)20.8(".)-197.6(In)]TJ
-1.0015 -1.0641 TD
[(a)-336.9(s)0(e)19.6(r)0(i)17.3(e)0(s)-327.5(o)0(f)-327.5(4)0(0)15.5(0)-336.5(ca)20.4(se)13.9(s,)-326.7(")13.4(l)0(o)13.2(c)0(a)20.4(l)0(i)16.5(z)0(e)14.7(d)0(")-323.2(d)0(i)13.2(s)0(e)19.6(a)0(s)19.6(e)0(,)-325.9(l)0(i)16.5(m)0(i)15.7(t)0(e)18.4(d)-336.5(to)-328.3(on)15.5(ly)]TJ
0 -1.0698 TD
[(on)15.5(e)-274.3(p)0(u)15.5(l)0(m)15.7(o)0(n)21.2(a)0(r)13.5(y)-273.9(ar)13.5(te)18.4(ry)82.2(,)-279.2(w)0(a)16.9(s)-280.8(fo)19.6(un)15.5(d)-273.9(i)0(n)-271.4(o)0(n)15.5(l)0(y)-265.7(1)39.1(1)-279.6(p)0(a)20.8(t)0(i)16.5(e)0(n)15.1(t)0(s)-266.9(\()0(3)14(%)0(\))]TJ
T*
[(an)15.1(d)-199.9(p)0(a)15.1(r)0(a)19.2(d)0(o)15.5(x)0(i)18.9(c)0(a)14.7(l)0(l)16.5(y)-199.9(ca)14.7(rr)18(ie)18.4(d)-205.6(a)-206(mu)18.1(ch)-195.4(po)15.5(or)19.6(er)-197(su)14.4(r)20.4(g)0(i)18.9(c)0(a)14.7(l)-202.3(pr)13.9(og)21.2(no)15.5(si)17.7(s)]TJ
T*
[(th)18.9(an)-189.7(th)18.9(e)-194.7(u)0(s)14.4(u)0(a)20.8(l)-196.6(mo)12.4(re)-185.6(ge)15.1(ne)20.8(ra)13.5(li)16.5(ze)20.4(d)-194.2(i)0(n)13.2(v)0(o)21.2(l)0(v)18.9(e)0(m)12(e)0(n)20.8(t)-196.6([9)13.9(2].)-197(Surgical)]TJ
0 -1.0641 TD
[(succes)-8.2(s)-178.4(i)0(s)-175.8(depe)-9.6(ndent)-177.3(on)-183.6(complete)-185.9(bilateral)-189.9(endarterect)-12.7(omy)]TJ
0 -1.0698 TD
[(of)-350.2(the)-346.5(entire)-353.2(pulmona)-11.3(ry)-344.6(tree)-349.3([103].)-354.5(V)52.2(irtuall)-11.2(y)-347.9(all)-348.9(patients)]TJ
T*
[(with)-472.7(severe)-475.2(PH,)-466(regard)-8.6(less)-469.2(of)-469.7(cause,)-473.2(have)-470.5(general)-10.5(ized)]TJ
0 -1.0641 TD
[(arteriopat)-13.5(hic)-266.8(chang)-10.3(es.)-265.3(These)-271.7(are)-272.2(often)-270(poorl)-7.8(y)-262.5(appreci)-10.5(ated)]TJ
0 -1.0698 TD
[(durin)-7.8(g)-404.8(convent)-8.5(ional)-413(angiog)-7.4(raphy)-409.8(which)-414.6(visualis)-10.3(es)-407.2(only)]TJ
T*
[(third)-283.3(order)-280.6(segme)-9(ntal)-275.7(vessel)-10.1(s,)-275.5(leavi)-9.4(ng)-274.7(25\26126)-282.7(division)-8.7(s)-275.1(o)0(f)]TJ
T*
[(the)-266.8(pu)-7.2(lmonary)-274.6(arteries)-272.5(before)-276(the)-266.8(capil)-9.4(lary)-269.2(bed)-270.2(which)-272.3(are)]TJ
0 -1.0641 TD
[(not)-334.7(show)-8.2(n)-330.8([63].)]TJ
1.0015 -1.0528 TD
[(Al)14.9(th)18.9(ou)15.5(gh)-291.7(pr)19.6(ox)15.5(im)15.7(al)-288.8(oc)15.1(cl)18.5(us)14.4(i)13.9(o)0(n)-297.4(o)0(f)-293.3(t)0(h)18.9(e)-302.8(pu)21.2(lm)15.7(on)15.5(ar)19.2(y)-302.4(a)0(r)19.2(t)0(e)12.8(r)0(i)17.3(e)0(s)]TJ
-1.0015 -1.0698 TD
[(\(m)16.5(ai)18.4(n,)-575.9(lo)18.9(ba)15.1(r)-582.8(o)0(r)-577.9(s)0(e)19.6(g)0(m)18.1(e)0(n)15.1(t)0(a)18.4(l)0(\))-574.6(i)0(s)-579.8(t)0(h)18.9(e)-581.6(de)15.1(fi)17.3(ni)18.9(ng)-576.3(fe)19.2(at)12.8(ur)19.6(e)-587.3(o)0(f)]TJ
0 -1.0641 TD
[(CT)18.1(EP)17.9(H,)-249.8(in)-248.6(th)18.9(e)-257.2(w)12.4(or)13.9(ds)-247.4(of)-247.8(F)]TJ
6.974 0 0 6.974 161.178 389.083 Tm
0.0001 Tc
[(EDU)24.1(LL)21.3(O)]TJ
/F5 1 Tf
9.963 0 0 9.963 191.112 389.083 Tm
0 Tc
[(et)-249(al)18.9(.)]TJ
/F4 1 Tf
2.2136 0 TD
[([6)19.6(])-264.1("...i)-8(t)-264.9(i)0(s)-266.9(becom)-7.8(-)]TJ
-15.5466 -1.0698 TD
[(ing)-437.2(incre)-8.6(asingly)-438.5(clear)-441.5(that)-435(hype)-9.1(rtensive)-441.2(changes)-440.2(in)-436.4(the)]TJ
T*
[(small)-280.8(vessels)-279.6(of)-270.6(the)-272.5(rema)-8.6(inder)-275.7(of)-276.3(the)-272.5(pulm)-8.6(onary)-273.3(vascul)-9(ar)]TJ
T*
[(bed)-389.7(have)-390.8(a)-388.1(maj)-8.2(or)-390.1(influence)-395.7(on)-388.5(its)-389.5(natur)-8.2(al)-385.6(h)-6.5(istory)56.2(.")-385.4(The)]TJ
0 -1.0641 TD
[(histopat)-9.1(hologi)-9.3(cal)-233.1(findings)-241.3(in)-231.5(the)-232.7(small)-240.9(pulmonary)-242(arteries)]TJ
0 -1.0698 TD
[(of)-452.7(pa)-7.6(tients)-457.2(with)-461.3(CTEPH)-458.1(cannot)-457.3(be)-457.2(distingu)-8.7(ished)-457.3(from)]TJ
T*
[(those)-298(in)-299.8(primary)-304.7(PH)-294.9([92].)-302.5(For)-299(unknown)-299.5(reason)-8.2(s)-292.2(imp)-7.8(rov-)]TJ
0 -1.0641 TD
[(ing)-323.3(the)-323.7(flow)-329.6(of)-321.8(blood)-324.9(throu)-7.8(gh)-320.2(the)-323.7(pulm)-8.6(onary)-324.5(arter)-10.2(ies)-324.9(by)]TJ
0 -1.0698 TD
[(thromboend)-15.1(arterectomy)47.2(,)-398.7(often)-406.5(has)-402.2(a)-399.5(benefic)-10.5(ial)-400.1(effect)-398.3(in)]TJ
T*
[(this)-253.7(condit)-9.7(ion.)-249.7(From)-257.4(this)-253.7(it)-251(may)-250.5(be)-252.3(inferred)-258.8(that)-252.9(extens)-9(ive)]TJ
T*
[(proxi)-7.8(mal)-429.3(occlusion)-429(is)-426.2(in)-425(some)-428.9(way)-433.4(contribut)-10.3(ing)-425.8(to)-425(the)]TJ
0 -1.0641 TD
[(pathop)-7.4(hysio)-7.4(logy)62.9(,)-438.6(but)-442.8(this)-441.5(does)-442.8(not)-442.8(establis)-10.7(h)-438.9(P)0(E)-437.3(a)0(s)-441.3(the)]TJ
0 -1.0698 TD
[(cause)-342(of)-333.2(the)-335.1(occlus)-9(ion.)]TJ
1.0015 -1.0527 TD
[(It)-415.2(is)-414.8(wi)14.9(de)20.8(ly)-419.3(ac)20.4(ce)14.7(pt)18.9(ed)-411.7(th)13.2(at)-414(ch)20.8(ro)13.9(ni)18.9(c)-422.3(P)0(H)-414.4(i)0(s)-414.8(a)0(n)-417.3(i)0(n)18.8(s)0(i)17.7(d)0(i)18.9(o)0(u)15.5(s)]TJ
-1.0015 -1.0641 TD
[(di)18.9(se)13.9(as)19.6(e)-410.9(w)0(i)14.9(t)0(h)-407.9(a)-410.9(lo)18.9(ng)-405.6(as)19.6(ym)12.4(pt)18.9(om)18.1(at)18.4(ic)-408.3(")13.4(h)0(o)15.5(n)0(e)20.8(y)0(m)12.4(o)0(o)21.2(n)-416.2(pe)20.8(ri)17.3(od)15.5(".)]TJ
0 -1.0698 TD
[(Th)17.1(er)19.2(e)-211.7(i)0(s)-198.6(n)0(o)-200.7(d)0(o)21.2(u)0(b)15.5(t)-208(th)18.9(at)18.4(,)-210.9(a)0(s)-196.6(w)0(i)14.9(t)0(h)-197.4(t)0(h)13.2(r)0(o)19.6(m)0(b)18.1(e)0(n)15.1(d)0(a)20.8(r)0(t)17.3(e)0(c)14.7(t)0(o)18.9(m)0(y)-203.8(p)0(e)20.8(r)0(f)18(o)0(r)25.3(-)]TJ
T*
[(me)17.7(d)-308.1(a)0(t)-305.9(o)0(t)18.9(h)0(e)20.8(r)-309.7(si)17.7(te)12.8(s,)-298.2(re)19.2(mo)12.4(va)20.8(l)-310.4(o)0(f)-299(l)0(a)12.8(r)20.4(ge)-297.8(ob)15.5(st)17.7(ru)19.6(ct)18.4(iv)13.2(e)-308.5(l)0(e)18.4(s)0(i)17.7(o)0(n)15.5(s)-309.2(in)]TJ
0 -1.0641 TD
[(th)18.9(e)-348.3(p)0(u)21.2(l)0(m)15.7(o)0(n)15.5(a)0(r)19.2(y)-342.2(ar)13.5(te)18.4(ri)17.3(es)-333.2(ha)15.1(s)-343.4(s)0(h)20(o)0(r)14(t)-344.6(an)20.8(d)-347.9(m)0(e)17.7(d)0(i)18.9(u)0(m)-334.7(t)0(e)12.8(r)0(m)-336.3(b)0(e)20.8(n)0(e)15.1(-)]TJ
0 -1.0698 TD
[(fi)17.3(ci)18.5(al)-544.9(ha)20.8(em)12(od)21.2(yn)15.5(am)17.7(ic)-539.2(ef)24.9(fe)19.2(ct)12.8(s)-548.3(i)0(n)-544.5(m)0(a)17.7(n)0(y)-542.1(c)0(a)20.4(s)0(e)13.9(s)0(.)-537.2(H)0(o)17.3(w)0(e)16.9(v)0(e)15.1(r)37.5(,)]TJ
T*
[(wh)17.3(en)-286.5(fo)13.9(l)13.9(l)0(o)13.2(w)12.4(-u)13.9(p)-296.7(s)0(t)17.7(u)0(d)21.2(i)0(e)18.4(s)-297.9(of)-287.6(mo)18.1(re)-288.1(th)18.9(an)-292.2(a)-291.4(f)0(e)13.5(w)-294.9(ye)15.1(ar)19.2(s)-297.9(b)0(e)20.8(c)0(o)15.1(m)0(e)]TJ
T*
[(av)15.1(ai)18.5(la)18.4(bl)18.9(e,)-240.6(i)13.9(t)-247.8(is)-238.4(po)15.5(ss)18.9(ib)18.9(le)-237.6(th)18.9(at)18.4(,)-245.1(a)0(f)13.5(t)0(e)18.4(r)-247.1(an)20.8(ot)13.2(he)20.8(r)-247.1(l)0(o)18.9(n)0(g)-240.5(h)0(o)21.2(n)0(e)15.1(y)0(m)18.1(o)0(o)15.5(n)]TJ
0 -1.0641 TD
[(pe)15.1(ri)17.3(od)21.2(,)-284.9(t)0(h)18.9(e)-280(PH)12.4(,)-279.2(a)0(n)15.1(d)-279.6(po)15.5(ss)18.9(ib)18.9(ly)-277.1(th)18.9(e)-280(v)0(a)15.1(s)0(c)19.6(u)0(l)13.2(a)0(r)-271(o)0(c)15.1(c)0(l)18.4(u)0(s)20(i)0(o)13.2(n)0(s)20(,)-279.2(ma)12(y)]TJ
0 -1.0698 TD
[(re)19.2(cu)15.1(r)-224.3(i)0(n)-214.5(c)0(a)20.4(s)0(e)13.9(s)-218.2(wh)17.3(er)13.5(e)-223.1(t)0(h)18.9(e)-223.1(ca)20.4(us)14.4(at)18.4(iv)18.9(e)-223.1(i)0(n)18.9(f)0(l)17.3(u)0(e)15.1(n)0(c)20.8(e)0(s)-219.4(p)0(e)20.8(r)0(s)18.4(i)0(s)17.7(t)0(.)-214.1(A)0(p)17.3(p)0(r)25.3(-)]TJ
T*
[(ox)15.5(im)21.4(at)12.8(el)18.4(y)-268.2(5)0(%)-260(o)0(f)-264.9(p)0(a)20.8(t)0(i)16.5(e)0(n)15.1(t)0(s)-261.2(w)12.4(ho)-263.3(ha)20.8(ve)-263.7(un)21.2(de)15.1(r)20.4(g)0(o)15.5(n)0(e)-258(p)0(u)15.5(l)0(m)15.7(o)0(n)21.2(a)0(r)13.5(y)]TJ
T*
[(th)18.9(ro)13.9(mb)18.1(en)20.8(da)15.1(rt)17.3(ec)14.7(t)13.9(o)0(m)12.4(y)-376.3(in)-373.8(S)11.4(a)0(n)-371.8(D)0(i)14.9(e)0(g)20.8(o)0(,)-371(C)0(A)12.6(,)-376(US)12.4(A)12.4(,)-381.7(ha)20.8(ve)-371.8(su)14.4(f-)]TJ
0 -1.0641 TD
[(fe)19.2(re)13.5(d)-205.6(a)-206(re)19.2(la)18.4(ps)20(e)-206(i)0(n)13.2(t)13.9(o)-205.6(s)0(e)13.9(v)0(e)20.8(r)0(e)-197(P)0(H)-198.2(a)0(f)19.2(t)0(e)12.8(r)-201.5(an)-201.1(i)13.9(n)0(t)13.2(e)0(r)19.2(v)0(a)15.1(l)-202.3(of)-196.6(mo)18.1(nt)13.2(hs)-196.2(or)]TJ
0 -1.0698 TD
[(ye)15.1(ar)19.2(s)-326.3([)0(1)19.6(0)0(4)15.5(])0(.)]TJ
/F7 1 Tf
25.4083 66.1583 TD
[(Can)-341.2(embolic)-342.5(occlus)-8.2(ion)-333.9(of)-333.2(the)-339.2(pulmona)-7.7(ry)-337.7(arterie)-10.9(s)-332(b)0(e)]TJ
0.3983 -1.0584 TD
[(distingu)-11.3(ished)-336.3(from)]TJ
/F1 1 Tf
8.3594 0 TD
[(in)-333.2(situ)]TJ
/F7 1 Tf
2.9705 0 TD
[(pulmona)-7.7(ry)-337.7(thrombosis?)]TJ
/F4 1 Tf
-10.9372 -1.6503 TD
[(Th)17.1(ro)14(mb)18.1(os)20(is)-221.3(of)-225.1(th)18.9(e)-228.8(p)0(u)15.5(l)13.9(mo)12.4(na)20.8(ry)-219.4(ar)13.5(te)18.4(ri)17.3(es)-219.4(is)-221.3(a)-228.8(v)0(e)15.1(r)0(y)-219.4(c)0(o)15.1(m)0(m)14.9(o)0(n)]TJ
-1.0015 -1.0584 TD
[(co)15.1(mp)18.1(li)16.5(ca)14.7(ti)22.2(on)-246.2(of)-247.8(ma)17.7(ny)-246.2(va)15.1(ri)17.3(et)18.4(ie)18.4(s)-258(o)0(f)-242.1(P)0(H)-249.4([)0(1)19.6(0)0(5)15.5(])0(.)-264.5(For)-264.9(e)-6.9(xample,)]TJ
T*
0 Tw
(C)Tj
6.974 0 0 6.974 316.006 723.571 Tm
0.0001 Tc
[(AL)78.4(VERL)88.4(Y)]TJ
/F5 1 Tf
9.963 0 0 9.963 348.378 723.571 Tm
0 Tc
[(et)-214.9(al.)]TJ
/F4 1 Tf
2.1567 0 TD
[([106])-217.6(found)-216(that)-218.8(~50%)-213.4(of)-213.7(patien)-10.2(ts)-210(with)-216.6(cor)]TJ
-6.0775 -1.0527 TD
[(pulm)-8.6(onale)-217.6(due)-218.9(to)-214.5(respi)-9.4(ratory)-221.1(failure)-224.7(had)-213.2(p)-6.5(ulmonary)-224.2(artery)]TJ
0 -1.0584 TD
[(throm)-10.9(bosis)-213.4(a)-6.9(t)]TJ
/F5 1 Tf
5.5483 0 TD
[(p)-6.5(ost)-210.7(mor)-7.4(tem)]TJ
/F4 1 Tf
4.9109 0 TD
[(.)-210.9(The)-6.8(se)-213.7(author)-9(s)-212.5(pointed)-221.1(out)-215.2(that)]TJ
-10.4592 -1.0584 TD
[(what)-516.2(their)-511.3(pathologi)-8.7(sts)-507.8(descri)-10.6(bed)-509.2(as)-503.9(pulm)-8.6(onary)-512.3(artery)]TJ
T*
[(throm)-10.9(bosis)-321.6(could)-319.6(not)-317.7(have)-322.5(been)-316.8(dist)-9(inguished)]TJ
/F5 1 Tf
18.8528 0 TD
[(ante)-324.5(mor-)]TJ
-18.8528 -1.0584 TD
(tem)Tj
/F4 1 Tf
1.6446 0 TD
[(from)-219.9(PE.)-215.8(P)]TJ
6.974 0 0 6.974 368.617 670.904 Tm
0.0001 Tc
(RESTI)Tj
/F5 1 Tf
9.963 0 0 9.963 389.99 670.904 Tm
0 Tc
[(et)-214.9(al.)]TJ
/F4 1 Tf
2.1567 0 TD
[([107])-217.6(observ)-7.8(ed)-218.2(chronic)-220.7(massive)]TJ
-10.2544 -1.0584 TD
[(pulm)-8.6(onary)-421.2(artery)-420.7(throm)-10.9(bosis)-418.3(in)-419.3(patients)-425(with)-421.5(lung)-420.8(dis-)]TJ
T*
[(ease,)-290.4(and)-287.2(found)-284.2(that)-287.1(it)-285.1(was)-286.7(invar)-8.2(iabl)-8.2(y)-279.6(locat)-9.4(ed)-280.8(on)-286.1(the)-283.9(side)]TJ
T*
[(of)-390.1(the)-380.7(most)-391(seriou)-10.1(s)-383.2(disease,)-387.3(imp)-7.8(lying)-389.8(retrograde)-391.6(propa-)]TJ
0 -1.0528 TD
[(gati)-8.2(on)-234.8(from)-242.7(peripheral)-244.4(to)-237.2(maj)-8.2(or)-236.4(arteries)-244.1(in)-237.2(diseased)-239.7(lungs)-7.4(.)]TJ
0 -1.0584 TD
[(In)-236.4(this)-230.9(seri)-8.6(es)-230.8(of)-230.7(over)-232.7(7,700)]TJ
/F5 1 Tf
10.721 0 TD
[(post)-228.6(mor)-7.4(tems)]TJ
/F4 1 Tf
5.3093 0 TD
[(,)-228(the)-232.7(inci)-8.2(dence)-232.7(of)]TJ
-16.0303 -1.0584 TD
[("chr)-8(onic)-364.3(mass)-9(ive)-363.6(thrombos)-8.7(is")-367.3(of)-361.6(the)-363.6(pulm)-8.6(onary)-364.3(arteries)]TJ
T*
[(was)-167.2(0.1%.)-164.7(Since)-165.6(this)-162.7(is)-158.7(the)-164.4(figur)-9.4(e)-160.5(given)-160.2(for)-164.8(CTEPH)-167.9(in)-157.6(other)]TJ
T*
[(seri)-8.6(es,)-327.9(it)-330.7(appears)-339.4(that)-332.6(these)-332.6(terms)-336.9(were)-333.7(being)-331(used)-334.7(inter-)]TJ
T*
[(cha)-8.8(ngeably)-350(in)-339.7(this)-350.4(study)-348.8([108])-348.4(As)-342.4(previ)-8.2(ously)-348.8(discussed,)]TJ
T*
[(chroni)-9(c)-171.9(pulm)-8.6(onary)-176.5(artery)-176(throm)-10.9(bosis)-173.6(can)-8.8(not)-169.7(be)-178.3(distingu)-8.7(is-)]TJ
T*
[(hed)-173.4(histolog)-8.7(ical)-8.6(ly)-168.9(from)-174.4(chroni)-9(c)-166.2(embol)-9.7(ization,)-173(consequ)-7.3(en)-7.6(t-)]TJ
T*
[(ly)-157.6(other)-156.2(authors)-158.9(have)-151.8(also)-160.7(used)-152.6(these)-156.1(terms)-160.5(interchange)-10.7(ably)]TJ
0 -1.0527 TD
[(wi)-7.8(thout)-270.3(maki)-9(ng)-269(assumpti)-11.1(ons)-270.9(as)-270.6(to)-265.7(causat)-9.4(ion)-272.1([109].)-274.8(Fibri-)]TJ
0 -1.0584 TD
[(nop)-8(eptide)-249.1(levels)-250.3(are)-249.4(elevat)-10.6(ed)-246.6(in)-248.6(patients)-254.2(with)-250.7(chronic)-249.1(PH,)]TJ
T*
[(indi)-7.8(cating)-408.5(ongoin)-7(g)-404.8(pulmonary)-412.7(vascular)-410.8(thrombos)-8.7(is,)-403.8(but)]TJ
T*
[(level)-9.4(s)-553.9(o)0(f)-549.4(plat)-8.2(elet)-554.9(prote)-8.2(ins)-552.2(and)-554.7(fibrinopep)-10.3(tide)-8.2(s)-548.3(d)0(o)-553.5(not)]TJ
T*
[(allo)-8.2(w)-277.9(patients)-282.7(who)-279.4(are)-277.8(classifi)-12.3(ed)-275.1(as)-276.3(having)-280.5(CTEPH)-281.7(to)-277.1(be)]TJ
T*
[(differentiated)-498.9(from)-498.8(those)-491.5(wi)-7.8(th)-487.6(prim)-10.2(ary)-493.7(PH)-494.1([108\2611)28(10].)]TJ
T*
[(Com)-10.2(plete)-453.2(occlus)-9(ion)-454.2(of)-452.7(centr)-8.6(al)-453.9(pulm)-8.6(onary)-455.4(arteries)-460.3(may)]TJ
T*
[(also)-234.7(be)-229.6(observ)-7.8(ed,)-224.2(seem)-8.2(ing)-232.3(as)-225.1(an)-229.6(inci)-8.2(dental)-232.1(finding,)-234(appar-)]TJ
T*
[(entl)-8.2(y)-353.6(without)-363.5(impo)-8.6(rtant)-357.7(haemo)-7.8(dynam)-7.4(ic)-357.1(effects,)-349.4(in)-356.7(some)]TJ
0 -1.0527 TD
[(cases)-303.3(of)-299("prima)-9.4(ry)-293.3(pulm)-8.6(onary)-296(hyp)-8(ertension")-303.5([1)31(1)27.7(1].)-299.4(PH)-294.9(of)]TJ
0 -1.0584 TD
[(any)-321.4(cause)-319.2(predisposes)-324(to)-316.9(thromb)-11.7(osis)-315.1(which,)-323.9(in)-311.2(some)-320.8(but)]TJ
T*
[(not)-403(all)-405.8(cases,)-406.1(may)-404.2(furt)-8.6(her)-402.6(elevate)-410.1(the)-403.4(pulmonary)-412.7(artery)]TJ
T*
[(press)-8.2(ure)-334.3([10,)-340(19,)-337.7(1)33.4(12].)]TJ
1.0015 -1.0528 TD
[(Th)17.1(e)-223.1(i)0(m)15.7(a)0(g)20.8(i)0(n)13.2(g)-217(te)18.4(ch)15.1(ni)18.9(qu)15.5(es)-208(wh)17.3(ic)12.8(h)-217(a)0(r)13.5(e)-217.4(us)14.4(ed)-206.8(to)-214.5(de)20.8(te)12.8(ct)-209.2(PE)-209.7(ca)14.7(n)]TJ
-1.0015 -1.0527 TD
[(de)15.1(mo)18.1(ns)14.4(tr)17.3(at)18.5(e)-359.7(o)0(c)15.1(c)0(l)18.5(u)0(s)14.4(i)0(o)18.9(n)-359.3(of)-355.9(pu)15.5(lm)15.7(on)21.2(ar)13.5(y)-359.3(a)0(r)13.5(t)0(e)18.4(r)0(i)17.3(e)0(s)19.6(,)-364.6(bu)21.2(t)-367.3(a)0(r)19.2(e)-365.4(no)21.2(t)]TJ
0 -1.0584 TD
[(ca)14.7(pa)15.1(bl)18.9(e)-433.7(o)0(f)-424.2(d)0(i)18.9(s)0(t)17.7(i)0(n)18.9(g)0(u)15.5(i)0(s)17.7(h)0(i)18.9(n)0(g)-422.6(t)0(h)18.9(e)-433.7(ca)14.7(us)20(e.)-428.3(Mo)19.3(st)-426.2(cl)18.5(in)18.9(ic)18.5(ia)12.8(ns)-423.8(ar)19.2(e)]TJ
T*
[(we)16.9(ll)-239.6(aw)16.9(ar)19.2(e)-245.9(t)0(h)13.2(a)0(t)-231.9(P)0(E)-238.2(i)0(s)-238.4(c)0(o)20.8(m)0(m)14.9(o)0(n)15.5(,)-245.1(an)20.8(d)-245.5(t)0(h)13.2(a)0(t)-231.9(t)0(h)13.2(e)-245.9(pr)19.6(es)19.6(en)15.1(ta)18.5(ti)16.5(on)-234.8(is)]TJ
T*
[(of)13.9(te)18.4(n)-507.2(v)0(e)15.1(r)0(y)-503.9(n)0(o)21.2(n)0(s)20(p)0(e)15.1(c)0(i)18.4(f)0(i)17.3(c)-513.3(or)-498.2(as)14(ym)18.1(pt)18.9(om)18.1(at)12.8(i)13.9(c)0(.)-502.3(C)0(o)16.5(n)0(s)20(e)0(q)15.1(u)0(e)15.1(n)0(t)18.8(l)0(y)81.5(,)]TJ
T*
[(re)13.5(ga)20.8(rd)14(le)18.4(ss)-402.2(of)-407.2(cl)18.5(in)18.9(ic)12.8(al)-402.7(fi)17.3(nd)15.5(in)18.9(gs)20(,)-415.8(p)0(a)20.8(t)0(i)16.5(e)0(n)15.1(t)0(s)-403.4(w)0(i)14.9(t)0(h)-402.3(c)0(h)15.1(r)0(o)19.6(n)0(i)18.9(c)-416.6(P)11.4(H)]TJ
T*
[(wh)17.3(o)-217(h)0(a)15.1(v)0(e)-206.8(v)0(e)15.1(n)0(t)18.9(i)0(l)16.5(a)0(t)18.4(i)0(o)18.8(n)-217(pe)15.1(rf)18(us)20(io)18.9(n)-217(m)0(i)15.7(s)0(m)16.9(a)0(t)12.8(c)0(h)-206.8(o)0(n)-206.4(a)-217.4(lu)18.9(ng)-206.4(sc)14(an)-206.8(or)]TJ
T*
[(ar)13.5(te)18.4(ri)17.3(al)-391.3(oc)20.8(cl)12.8(us)20(io)18.8(n)-399.1(a)0(t)-391.3(p)0(u)15.5(l)0(m)15.7(o)0(n)21.2(a)0(r)19.2(y)-399.1(an)15.1(gi)18.8(og)15.5(ra)19.2(ph)15.5(y)73.2(,)-398.7(ar)19.2(e)-399.5(u)0(s)14.4(u)0(a)20.8(l)0(l)16.5(y)]TJ
T*
[(di)13.2(ag)20.8(no)15.5(se)19.6(d)-239.8(a)0(s)-230.7(h)0(a)15.1(v)0(i)18.9(n)0(g)-229.1(r)0(e)19.2(c)0(u)15.1(r)0(r)18(e)0(n)15.1(t)-236.5(PE)17.9(.)-239.4(B)0(u)16.5(t)-242.2(t)13.9(h)0(e)15.1(s)0(e)-230.7(a)0(r)19.2(t)0(e)12.8(r)0(i)17.3(o)0(g)21.2(r)0(a)13.5(p)0(h)21.2(i)0(c)]TJ
T*
[(ch)15.1(an)15.1(ge)20.8(s)-366.2(a)0(r)13.5(e)-365.4(so)14.4(m)13.2(e)0(t)12.8(i)0(m)15.7(e)0(s)-355.9(f)0(o)13.9(u)0(n)21.2(d)-365(to)-362.4(be)-360.4(du)21.2(e)-371.1(t)13.9(o)-370.7(a)0(g)20.8(e)0(n)15.1(e)0(s)19.6(i)0(s)17.7(,)-370.3(ar)19.2(t-)]TJ
0 -1.0527 TD
[(er)13.5(it)16.5(is)17.7(,)-330.4(s)0(a)19.6(r)0(c)13.5(o)0(m)18.1(a)0(,)-325.9(f)0(i)17.3(b)0(r)19.6(o)0(s)20(i)0(s)17.7(,)-336.1(tu)18.9(mo)18.1(ur)-327.5(em)17.7(bo)21.2(li)16.5(sm)16.9(,)-336.1(o)0(r)-321.8(t)0(h)18.8(r)0(o)14(m)0(b)18.1(o)0(s)20(i)0(s)]TJ
0 -1.0584 TD
[(of)-213.7(th)18.9(e)-223.1(p)0(u)21.2(l)0(m)15.7(o)0(n)15.5(a)0(r)19.2(y)-222.7(ar)19.2(te)18.4(ry)-213.7([1)48.1(13)21.2(,)-233.7(1)33.4(15].)-231.9(Pa)-6.8(tients)-235.3(with)-233.7(proxi)-7.8(mal)]TJ
T*
[(vascul)-9(ar)-310.8(occlusion)-315.2(and)-304.3(PH)-312(due)-304.3(to)-311.2(fibrosing)-311.9(medi)-9(astinit)-10.8(is)]TJ
T*
[(also)-695.6(have)-686.7(clin)-8.2(ical)-685.8(p)-6.5(resentation,)-697.1(scintigr)-10.7(aphic,)-690.2(angio-)]TJ
T*
[(graphi)-9(c)-507.6(and)-509.2(right)-516.6(heart)-515.1(catheteri)-11.5(zation)-510.9(findi)-10.2(ngs)-509.9(which)]TJ
T*
[(are)-289.2(indisti)-10.4(nguishable)-293.2(from)-288.2(those)-286.6(of)-287.7(patients)-294.1(with)-284.9(CTEP)-9.5(H)]TJ
T*
[([1)25.3(16].)-340(The)-6.8(re)-339.3(are)-340.4(many)-342.3(nonem)-7.4(boli)-7.8(c)-336.9(causes)-343.9(of)-338.9(ven)-8.4(tilation)]TJ
T*
[(perfus)-9.4(ion)-243.7(mis)-9(match)-249.2(in)-242.9(pati)-8.2(ents)-246(with)-245.1(CTEP)-9.5(H)-243.7([)0(1)31(17].)-249(These)]TJ
0 -1.0527 TD
[(alte)-8.6(rnative)-427.9(diagno)-7.4(ses)-420.5(are)-420.1(often)-423.6(only)-426.5(establis)-10.7(hed)-418.1(at)]TJ
/F5 1 Tf
21.1404 0 TD
[(po)-7.2(st)]TJ
-21.1404 -1.0584 TD
[(mor)-7.4(tem)]TJ
/F4 1 Tf
3.3062 0 TD
[(or)-276.3(at)-271.8(the)-272.5(time)-273.1(of)-270.6(atte)-8.6(mpted)-271.5(surgery)63.8(.)-273.5(I)0(n)-270.6(u)0(p)-269(t)0(o)-271.4(30%)]TJ
-3.3062 -1.0584 TD
[(of)-395.8(cases)-400.1(in)-390.9(whic)-9.8(h)-387.7(alte)-8.6(rnative)-399.5(speci)-8.2(fic)-393.6(inves)-7.8(tigations)-399.3(are)]TJ
T*
[(perfor)-9.8(med,)-233.8(an)-235.2(angiog)-7.4(raphi)-8.2(c)-228.8(diagno)-7.4(sis)-234.7(of)-230.7(throm)-10.9(boemb)-7.4(olic)]TJ
T*
[(occ)-8.8(lusion)-380.4(may)-381.4(prove)-375.7(to)-379.5(be)-377.5(eith)-8.2(er)-373.4(fals)-8.6(e)-376.7(positive)-384.7(or)-378.7(false)]TJ
T*
[(neg)-8.4(ative)-333.7([1)25.3(18].)]TJ
1.0015 -1.0471 TD
[(An)11.6(t)13.9(i)0(c)12.8(o)0(a)20.8(g)0(u)15.5(l)0(a)18.4(n)0(t)18.8(s)-434.4(ar)19.2(e)-433.7(o)0(f)19.6(t)0(e)18.4(n)-433.3(us)14.4(ed)-423(i)13.9(n)-433.3(ca)14.7(se)19.6(s)-434.4(o)0(f)-424.2(C)11.6(TE)18.7(PH)-425.8(in)]TJ
-1.0015 -1.0584 TD
[(th)13.2(e)-456.4(e)0(x)20.8(p)0(e)15.1(c)0(t)18.4(a)0(t)18.5(i)0(o)18.8(n)-456(of)-447(re)13.5(du)21.2(ci)18.4(ng)-445.4(th)13.2(e)-456.4(p)0(r)19.6(o)0(b)21.2(a)0(b)15.1(i)0(l)16.5(i)0(t)16.5(y)-456(of)-447(re)19.2(cu)15.1(rr)18(en)20.8(t)]TJ
T*
[(de)15.1(ep)-332(ve)15.1(no)21.2(us)-332.8(th)18.9(ro)14(mb)18.1(os)20(is)17.7(.)-341.8(H)0(o)17.3(w)0(e)16.9(v)0(e)15.1(r)37.5(,)-341.8(r)0(e)19.2(s)0(p)20(o)0(n)15.5(s)0(e)-333.2(t)0(o)-334(a)0(n)20.8(t)0(i)16.5(c)0(o)15.1(a)0(g)20.8(-)]TJ
T*
[(ul)13.2(an)20.8(t)-589.3(t)13.9(he)15.1(ra)19.2(py)-576.3(do)15.5(es)-577.9(no)21.2(t)-589.3(n)0(e)20.8(c)0(e)14.7(s)0(s)18.9(a)0(r)19.2(i)0(l)16.5(y)-586.9(im)15.7(pl)18.9(y)-586.9(t)0(h)18.9(a)0(t)-579.1(v)0(e)20.8(n)0(o)15.5(u)0(s)]TJ
8.966 0 0 8.966 58.28 797.499 Tm
(444)Tj
7.472 0 0 7.472 243.893 797.499 Tm
0.0001 Tc
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(445)Tj
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T*
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[(four)-290.7(cases)-290(\(1980\2611989\).)]TJ
/F5 1 Tf
9.9902 0 TD
[(J)-290.1(A)0(m)-296.6(V)104.5(et)-292(Med)-289.6(Assoc)]TJ
/F4 1 Tf
8.498 0 TD
[(1991;)-290.7(198:)]TJ
-18.4882 -1.1128 TD
(679\261682.)Tj
-2.5165 -1.1128 TD
[(75.)-1266.5(Egermayer)-223.3(P)103.1(,)-217.9(T)60.2(own)-223.1(GI,)-221.1(Peacock)-228.1(AJ.)-221.4(The)-223(role)-222.4(of)-227.6(serotonin)]TJ
2.5165 -1.1192 TD
[(in)-368.1(the)-373.7(pathophysiology)-373.5(of)-366.7(acute)-372.2(and)-371.3(chronic)-372.4(pulmonary)]TJ
0 -1.1128 TD
(hypertension.)Tj
/F5 1 Tf
5.7033 0 TD
(Thorax)Tj
/F4 1 Tf
3.2057 0 TD
[(1999;)-334.9(54:)-336(161\261168.)]TJ
-11.4255 -1.1128 TD
[(76.)-1266.5(Fadel)-535.4(E,)-530.7(Riou)-536.2(JY)123(,)-534(Mazamanian)-536.1(M,)]TJ
/F5 1 Tf
18.1847 0 TD
[(et)-532.3(al)]TJ
/F4 1 Tf
2.0107 0 TD
[(.)-534(Pulmonary)]TJ
-17.6789 -1.1128 TD
[(thromboendarterectomy)-887.1(for)-885.6(chronic)-878.2(thromboembolic)]TJ
0 -1.1192 TD
[(obstruction)-344.9(of)-347.7(the)-348.4(pulmonary)-348.2(artery)-348.6(in)-349.1(piglets.)]TJ
/F5 1 Tf
19.1584 0 TD
[(J)-347(Thorac)]TJ
-19.1584 -1.1128 TD
[(Car)33.6(diovasc)-334.7(Sur)31.9(g)]TJ
/F4 1 Tf
7.069 0 TD
[(1999;)-334.9(1)32.1(17:)-329.7(787\261793.)]TJ
-9.5855 -1.1128 TD
[(77.)-1266.5(Lang)-431.2(IM,)-433.5(Klepetko)-433.5(W)83.4(,)-432.9(Pabinger)-433.7(I.)-433.3(No)-432.2(increased)-435.3(prev-)]TJ
2.5165 -1.1192 TD
[(alence)-491.6(of)-493.1(Factor)-491.6(V)-489.7(Leiden)-495.6(mutation)-491.6(in)-494.6(chronic)-492.5(major)]TJ
0 -1.1128 TD
[(vessel)-387(thromboembolic)-396.3(hypertension)-398.7(\(CTEPH\).)]TJ
/F5 1 Tf
19.6895 0 TD
[(Thr)27(omb)]TJ
-19.6895 -1.1191 TD
(Haemost)Tj
/F4 1 Tf
3.8633 0 TD
[(1996;)-328.6(76:)-336(476\261477.)]TJ
-6.3798 -1.1128 TD
[(78.)-1266.5(Auger)-576.9(WR,)-581.2(Permpikul)-583.1(P)103.1(,)-578.3(Moser)-575.4(KM.)-581.2(Lupus)-577.5(antico-)]TJ
2.5165 -1.1128 TD
[(agulant,)-433.6(heparin)-441.9(use,)-432.3(and)-434.5(thrombocytopenia)-443.7(in)-437.7(patients)]TJ
0 -1.1192 TD
[(with)-221(chronic)-220.6(thromboembolic)-225.6(hypertension:)-223.5(a)-226.9(preliminary)]TJ
0 -1.1128 TD
(report.)Tj
/F5 1 Tf
2.9338 0 TD
[(Am)-334.6(J)-334.4(Med)]TJ
/F4 1 Tf
4.5209 0 TD
[(1995;)-328.6(99:)-336(392\261396.)]TJ
-9.9712 -1.1128 TD
[(79.)-1266.5(Azarian)-324.9(R,)-329.6(Brenot)-327.2(F)71.5(,)-325.4(Sitbon)-329.1(O,)]TJ
/F5 1 Tf
15.5038 0 TD
[(et)-323.6(al)]TJ
/F4 1 Tf
1.802 0 TD
[(.)-325.4(Pulmonary)-334.1(arterial)]TJ
-14.7893 -1.1128 TD
[(hypertension)-683.2(of)-682.8(chronic)-688.5(thrombo-embolic)-687.6(origin,)-682.1(70)]TJ
0 -1.1192 TD
(patients.)Tj
/F5 1 Tf
3.6546 0 TD
[(Pr)34.3(esse)-335(Med)]TJ
/F4 1 Tf
5.0267 0 TD
[(1994;)-334.9(23:)-329.6(1017\2611022.)]TJ
-11.1979 -1.1128 TD
[(80.)-1266.5(De)-330.8(Clerck)-339.7(LS,)-332.7(Michielson)-338.6(PP)105(,)-338(Ramael)-334(MR,)]TJ
/F5 1 Tf
20.5811 0 TD
[(et)-336.3(al)]TJ
/F4 1 Tf
1.8147 0 TD
[(.)-331.7(Portal)]TJ
-19.8792 -1.1128 TD
[(and)-428.2(pulmonary)-430.4(vessel)-431.2(thrombosis)-428.5(associated)-437.4(with)-429.7(syst-)]TJ
0 -1.1192 TD
[(emic)-298.9(lupus)-304.5(erythematosus)-306.2(and)-301.8(anticardiolipin)-310.4(antibodies.)]TJ
/F5 1 Tf
0 -1.1128 TD
[(J)-328.1(Rheumatol)]TJ
/F4 1 Tf
5.3998 0 TD
[(1991;)-334.9(18:)-336(1919\2611921.)]TJ
-7.9163 -1.1128 TD
[(81.)-1266.5(Marz)-422.8(W)83.4(,)-426.6(T)28.6(rommlitz)-431.2(M,)-426.7(Scharrer)-426.7(I,)-427(Gross)-427.7(W)83.4(.)-426.6(Apolipo-)]TJ
2.5165 -1.1128 TD
[(protein)-412.9(\(a\))-417.5(concentrations)-424.9(are)-416.3(not)-411.8(related)-418.8(to)-418.7(the)-418(risk)-413.5(of)]TJ
0 -1.1192 TD
[(venous)-402.6(thrombosis.)]TJ
/F5 1 Tf
8.2893 0 TD
[(Blood)-408(Coagul)-402.4(Fibrinolysis)]TJ
/F4 1 Tf
11.3117 0 TD
[(l991;)-406.9(2:)]TJ
-19.601 -1.1192 TD
(595\261599.)Tj
-2.5165 -1.1065 TD
[(82.)-1266.5(Ignatescu)-460.8(M,)-458.3(Kostner)-459.3(K,)-460.9(Zorn)-457.7(G,)]TJ
/F5 1 Tf
17.1857 0 TD
[(et)-462.7(al)]TJ
/F4 1 Tf
1.9411 0 TD
[(.)-458.2(Plasma)-462.1(Lp\(a\))]TJ
-16.6103 -1.1192 TD
[(levels)-476.7(are)-479.5(increased)-479.6(in)-475.6(patients)-478(with)-480.3(chronic)-479.9(thrombo-)]TJ
0 -1.1128 TD
[(embolic)-603.3(pulmonary)-607.4(hypertension.)]TJ
/F5 1 Tf
14.6755 0 TD
[(Thr)33.4(omb)-602.5(Haemostas)]TJ
/F4 1 Tf
-14.6755 -1.1192 TD
[(1998;)-328.6(80:)-336(231\261232.)]TJ
-2.5165 -1.1128 TD
[(83.)-1266.5(Schafer)-792.9(AI,)-796.5(Kroll)-796.8(MH.)-789.9(Non)-798.5(atheromatous)-792.3(arterial)]TJ
2.5165 -1.1128 TD
(thrombosis.)Tj
/F5 1 Tf
4.9825 0 TD
[(Annu)-336.6(Rev)-330.3(Med)]TJ
/F4 1 Tf
6.3419 0 TD
[(1993;)-334.9(44:)-336(155\261170.)]TJ
-13.8408 -1.1128 TD
[(84.)-1266.5(Sompradeek)-627.9(S,)-633.3(Fedullo)-631.8(PF)73.4(,)-635.2(L)0(e)-628.2(D)0(T)70.1(.)-628.9(Congenital)-632.3(and)]TJ
2.5165 -1.1128 TD
[(acquired)-359(thrombophilias)-366.6(in)-355.5(patients)-364.2(with)-360.1(chronic)-366.1(throm-)]TJ
0 -1.1192 TD
[(boembolic)-501.1(pulmonary)-506.2(hypertension.)]TJ
/F5 1 Tf
15.371 0 TD
[(Am)-505.3(J)-498.8(Respir)-510.8(Crit)]TJ
-15.371 -1.1128 TD
[(Car)33.6(e)-334.4(Med)]TJ
/F4 1 Tf
4.3818 0 TD
[(1999;)-334.9(159:)-329.1(A358.)]TJ
-6.8983 -1.1128 TD
[(85.)-1266.5(Peacock)-430.4(AJ.)-436.3(Primary)-437.3(pulmonary)-436.7(hyptertension.)]TJ
/F5 1 Tf
22.459 0 TD
(Thorax)Tj
/F4 1 Tf
-19.9425 -1.1191 TD
[(1999;)-328.6(54:)-336(1)32.1(107\2611)34.2(1)25.8(18.)]TJ
-2.5165 -1.1065 TD
[(86.)-1266.5(Moser)-322.5(KM,)-328.3(Bloor)-328(CM.)-329.8(Pulmonary)-327.8(vascular)-328.6(lesions)-325.8(occ-)]TJ
2.5165 -1.1192 TD
[(urring)-317.4(in)-317.5(patients)-320(with)-315.9(chronic)-321.8(major)-318.6(vessel)-323.7(thromboem-)]TJ
T*
[(bolic)-185.4(pulmonary)-190.1(hypertension.)]TJ
/F5 1 Tf
12.2095 0 TD
(Chest)Tj
/F4 1 Tf
2.447 0 TD
[(1993;)-183.2(103:)-190(685\261692.)]TJ
-17.173 -1.1065 TD
[(87.)-1266.5(Egermayer)-337.1(P)103.1(.)-331.7(Follow-up)-338.1(for)-341.8(death)-334.5(or)-335.1(recurrence)-344.4(is)-331.4(not)-336(a)]TJ
2.5165 -1.1192 TD
[(reliable)-294.2(way)-292.4(of)-297.1(assessing)-293(the)-297.8(accuracy)-292.9(of)-297.1(diagnostic)-293.6(tests)]TJ
0 -1.1128 TD
[(for)-171.1(thromboembolic)-175(disease.)]TJ
/F5 1 Tf
11.3117 0 TD
(Chest)Tj
/F4 1 Tf
2.4343 0 TD
[(1997;)-170.6(1)32.1(1)32.1(1)0(:)-178.4(1410\2611413.)]TJ
-16.2625 -1.1128 TD
[(88.)-1266.5(Henry)-608.5(JW)82.7(,)-603.6(Relyea)-610.4(B,)-607.8(Stein)-607.6(PD.)-604.4(Continuing)-613.8(risk)-609.5(of)]TJ
2.5165 -1.1192 TD
[(thromboemboli)-416(among)-410.1(patients)-414.8(with)-417(normal)-412.9(pulmonary)]TJ
0 -1.1128 TD
(angiograms.)Tj
/F5 1 Tf
5.2038 0 TD
(Chest)Tj
/F4 1 Tf
2.5924 0 TD
[(1995;)-334.9(107:)-335.5(1375\2611378.)]TJ
17.6852 73.5671 TD
[(89.)-1266.5(Bergqvist)-582.2(D.)-587.4(The)-596.1(role)-589.1(of)-588(vena)-591.9(caval)-593.5(interruption)-593.2(in)]TJ
2.5165 -1.1191 TD
[(patients)-231.4(with)-227.3(venous)-225.5(thromboembolism.)]TJ
/F5 1 Tf
16.0855 0 TD
[(Pr)34.3(og)-226.6(Car)27.2(diovasc)]TJ
-16.0855 -1.1128 TD
(Dis)Tj
/F4 1 Tf
1.7072 0 TD
[(1994;)-334.9(XXXVII:)-336.4(25\26137.)]TJ
-4.2237 -1.1128 TD
[(90.)-1266.5(Ballew)-369.7(KA,)-362.6(Philbrick)-368.6(JT)72.2(,)-363.3(Becker)-368.7(DM.)-366.3(V)104.7(ena)-364.8(caval)-365.9(filter)]TJ
2.5165 -1.1128 TD
(devices.)Tj
/F5 1 Tf
3.5535 0 TD
[(Clin)-329.9(Chest)-334.3(Med)]TJ
/F4 1 Tf
6.7213 0 TD
[(1995;)-334.9(16:)-336(295\261305.)]TJ
-12.7912 -1.1128 TD
[(91.)-1266.5(Michel)-210.6(RP)98.9(,)-211.6(H)0(u)-210.9(F)71.5(,)-211.6(Meyrick)-208.7(BO.)-212.2(Myoendothelial)-217.4(junctional)]TJ
2.5165 -1.1192 TD
[(complexes)-303.7(in)-304.9(postobstructive)-308.3(pulmonary)-303.9(vasculopathy:)-304.5(a)]TJ
0 -1.1128 TD
[(quantitative)-536.2(electron)-538.4(microscope)-538.1(study)62.2(.)]TJ
/F5 1 Tf
16.8822 0 TD
[(Experim)-537.5(Lung)]TJ
-16.8822 -1.1192 TD
(Res)Tj
/F4 1 Tf
1.7578 0 TD
[(1995;)-334.9(21:)-336(437\261452.)]TJ
-4.2743 -1.1065 TD
[(92.)-1266.5(Hirsch)-295.4(AM,)-296.7(Moser)-297.2(KM,)-296.7(Auger)-292.3(WR,)-296.7(Channick)-293.4(RN,)-294.4(Fed-)]TJ
2.5165 -1.1192 TD
[(ullo)-445.3(PF)73.4(.)-439.2(Unilateral)-450.6(pulmonary)-443(artery)-449.7(thrombotic)-447.3(occlu-)]TJ
0 -1.1128 TD
[(sion.)-244.7(Is)-247.7(distal)-251.7(arteriopathy)-248.9(a)-245.9(consequence?)]TJ
/F5 1 Tf
16.9454 0 TD
[(Am)-246.1(Rev)-248.1(Respir)]TJ
-16.9454 -1.1192 TD
[(Crit)-337.4(Car)33.6(e)-334.4(Med)]TJ
/F4 1 Tf
6.3103 0 TD
[(1996;)-334.9(154:)-329.1(491\261496.)]TJ
-8.8268 -1.1128 TD
[(93.)-1266.5(Shure)-344.5(D.)-340.8(Thrombendartectomy:)-347.1(some)-342.2(unanswered)-347.4(ques-)]TJ
2.5165 -1.1128 TD
(tions.)Tj
/F5 1 Tf
2.5102 0 TD
[(Ann)-330.8(Thorac)-331.6(Sur)25.6(g)]TJ
/F4 1 Tf
7.3283 0 TD
[(1996;)-334.9(62:)-336(1253\2611254.)]TJ
-12.355 -1.1128 TD
[(94.)-1266.5(W)70.8(eis)-330.6(M,)-331.9(von)-333.6(Scheidt)-334.4(W)83.4(.)-331.7(Cardiac)-332.6(allograft)-339.2(vasculopathy)57.8(.)]TJ
2.5165 -1.1128 TD
[(A)-331.6(review)60.1(.)]TJ
/F5 1 Tf
4.2553 0 TD
[(Cir)24.8(culation)]TJ
/F4 1 Tf
4.875 0 TD
[(1997;)-334.9(96:)-336(2069\2612077.)]TJ
-11.6468 -1.1128 TD
[(95.)-1266.5(Sevitt)-445(S,)-443.6(W)77.1(alton)-444.6(KW)80.6(.)-439.2(Atherosclerotic)-450(lesions)-446(from)-444.4(the)]TJ
2.5165 -1.1191 TD
[(reduction)-222(of)-221.3(pulmonary)-221.7(emboli.)]TJ
/F5 1 Tf
12.747 0 TD
[(Ather)33.6(oscler)30.3(osis)]TJ
/F4 1 Tf
6.3103 0 TD
[(1986;)-221.1(59:)]TJ
-19.0573 -1.1128 TD
(173\261185.)Tj
-2.5165 -1.1128 TD
[(96.)-1266.5(Uchida)-457.4(Y)123.6(,)-458.2(Oshima)-460.7(T)72.9(,)-458.2(Hirose)-466.1(J,)-458.8(Sasaki)-460.2(T)72.9(,)-458.2(Morizuki)-457.3(S,)]TJ
2.5165 -1.1128 TD
[(Morita)-414.1(T)72.9(.)-407.6(Angioscopic)-414.2(detection)-412.9(of)-410.9(residual)-413.4(pulmonary)]TJ
0 -1.1191 TD
[(thrombi)-282.2(in)-279.6(the)-278.8(diff)10.4(erential)-281.6(diagnosis)-280.5(of)-278.2(pulmonary)-284.9(embo-)]TJ
0 -1.1128 TD
(lism.)Tj
/F5 1 Tf
2.2826 0 TD
[(Am)-328.3(Heart)-339.2(J)]TJ
/F4 1 Tf
5.071 0 TD
[(1995;)-328.6(130:)-335.5(854\261859.)]TJ
-9.8701 -1.1128 TD
[(97.)-1266.5(Kodama)-343.1(I,)-344.8(Sugada)-342.8(Y)123.6(,)-338(Shimizu)-349.2(T)72.9(,)-344.3(Hoshi)-339.4(S.)-342.4(Proceedings:)]TJ
2.5165 -1.1192 TD
[(pulmonary)-247(hypertension)-253.3(associated)-254.1(with)-246.3(marked)-252.2(pulmon-)]TJ
0 -1.1128 TD
[(ary)-309.1(arteriosclerosis)-316.8(and)-314.4(thrombus)-312.2(formation.)]TJ
/F5 1 Tf
18.0962 0 TD
[(Japn)-307.6(Cir)24.8(c)-309.1(J)]TJ
/F4 1 Tf
-18.0962 -1.1192 TD
[(1975;)-334.9(39:)-329.6(874.)]TJ
-2.5165 -1.1065 TD
[(98.)-1266.5(Y)92(amamoto)-615.4(M.)-610.1(Pathology)-618.2(of)-613.3(experimental)-616.3(pulmonary)]TJ
2.5165 -1.1192 TD
[(bone)-155.8(marrow)-155.6(embolism.)-160(II)-159(Postembolic)-154.5(pulmonary)-158.5(arterio-)]TJ
0 -1.1128 TD
[(sclerosis)-244.5(and)-232.2(pulmonary)-240.7(hypertension)-240.6(in)-241.7(rabbits)-243.4(receiving)]TJ
0 -1.1192 TD
[(an)-302.3(intravenous)-304.4(infusion)-306.4(of)-303.5(allogeneic)-304.6(bone)-301.2(marrow)59.4(.)]TJ
/F5 1 Tf
21.0047 0 TD
(Acta)Tj
-21.0047 -1.1192 TD
[(Pathol)-334(Japn)]TJ
/F4 1 Tf
5.248 0 TD
[(1987;)-334.9(37:)-329.7(705\261724.)]TJ
-7.7645 -1.1065 TD
[(99.)-1266.5(Moore)-245.5(GW)80.6(,)-243.2(Smith)-249.3(RRL,)-248.2(Hutchins)-245.2(GM.)-246.1(Pulmonary)-251.9(artery)]TJ
2.5165 -1.1192 TD
[(atherosclerosis.)-285.2(Correlation)-285.9(with)-284.2(systemic)-289(atherosclerosis)]TJ
0 -1.1128 TD
[(and)-257.5(hypertensive)-259.4(pulmonary)-253.3(vascular)-259(disease.)]TJ
/F5 1 Tf
18.4692 0 TD
[(Ar)27.9(ch)-258(Path-)]TJ
-18.4692 -1.1192 TD
[(ol)-330.2(Lab)-338.5(Med)]TJ
/F4 1 Tf
5.0836 0 TD
[(1982;)-328.6(106:)-335.5(378\261380.)]TJ
-7.6001 -1.1128 TD
[(100.)-766.4(Sofia)-315.3(M,)-306.6(Faraone)-317.8(S,)-310.8(Alifano)-315.1(M,)]TJ
/F5 1 Tf
15.744 0 TD
[(et)-317.3(al)]TJ
/F4 1 Tf
1.7957 0 TD
[(.)-306.4(Endothelin)-315.1(abnor-)]TJ
-15.0232 -1.1128 TD
[(malities)-570.8(in)-564.1(patients)-566.6(with)-568.8(pulmonary)-563.1(embolism.)]TJ
/F5 1 Tf
20.5621 0 TD
(Chest)Tj
/F4 1 Tf
-20.5621 -1.1192 TD
[(1997;)-334.9(1)32.1(1)32.1(1)0(:)-330.2(544\261549.)]TJ
-2.5165 -1.1065 TD
[(101.)-766.4(Robin)-516.7(ED,)-520.8(Cross)-524(CE,)-515.9(Kroetz)-521.6(F)71.5(,)-515.1(T)60.2(otten)-520.5(RS,)-517.3(Bron)-522.1(K.)]TJ
2.5165 -1.1192 TD
[(Pulmonary)-403.7(hypertension)-398.7(and)-402.9(unilateral)-403.1(pleural)-406.4(constric-)]TJ
0 -1.1128 TD
[(tion)-262(with)-265.3(speculation)-267.6(on)-258.2(pulmonary)-266(vasoconstrictive)-269.4(sub-)]TJ
0 -1.1192 TD
(stance.)Tj
/F5 1 Tf
3.0476 0 TD
[(Ar)27.9(ch)-333.9(Intern)-336.4(Med)]TJ
/F4 1 Tf
7.0753 0 TD
[(1966;)-334.9(1)32.1(18:)-329.7(391\261400.)]TJ
-12.6395 -1.1128 TD
[(102.)-766.4(Ross)-555.2(R,)-557.2(W)32.8(ight)-559.1(TN,)-552.4(Strandness)-555.2(E,)-556(Thiele)-561.2(B.)-550.9(Human)]TJ
2.5165 -1.1128 TD
[(atherosclerosis.)-342.1(1)-328.3(Cell)-336(constitution)-341.9(and)-333.4(characteristics)-339.9(of)]TJ
0 -1.1192 TD
[(advanced)-355.4(lesions)-357.4(of)-354(the)-354.7(superficial)-358.1(femoral)-362.6(artery)62.4(.)]TJ
/F5 1 Tf
20.7075 0 TD
[(Am)-353.5(J)]TJ
-20.7075 -1.1128 TD
(Pathol)Tj
/F4 1 Tf
2.9781 0 TD
[(1984;)-334.9(1)32.1(14:)-329.7(79\26193.)]TJ
-5.4946 -1.1128 TD
[(103.)-766.4(Jamieson)-596.5(SW)85.3(.)-597.3(Pulmonary)-593.3(thrombendartectomy)54.2(.)]TJ
/F5 1 Tf
23.0217 0 TD
(Heart)Tj
/F4 1 Tf
-20.5052 -1.1128 TD
[(1998;)-334.9(79:)-329.6(1)32.1(18\261120.)]TJ
-2.5165 -1.1128 TD
[(104.)-766.4(Moser)-392.1(KM,)-391.6(Fedullor)-392(PF)73.4(.)-388.6(Acute)-394.7(and)-390.3(chronic)-391.3(pulmonary)]TJ
2.5165 -1.1192 TD
(thromboembolism.)Tj
/F5 1 Tf
8.2388 0 TD
(In)Tj
/F4 1 Tf
0.8283 0 TD
[(:)-722.7(Peacock)-721.2(AJ,)-727.2(\(ed\))-720.5(Pulmonary)]TJ
-9.0671 -1.1128 TD
[(Circulation.)-473.6(A)-464.4(Handbook)-466.9(for)-468.3(Clinicians.)-474.4(London,)-464.9(UK,)]TJ
0 -1.1192 TD
[(Chapman)-331.4(&)-336.5(Hall)-334.6(Medical,)-339.2(1996;)-328.6(pp.)-337(391\261422.)]TJ
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