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The article “Vascular Histomolecular Analysis By Sequential Endoarterial Biopsy in a Shunt Model of Pulmonary Hypertension” in Pulmonary Circulation, Volume 3, Number 1, January to March 2013, pp. 50-57 by Abraham Rothman, Robert G. Wiencek, William N. Evans, Humberto Restrepo, Valeri Sarukhanov, Erkki Ruoslahti, Roy Williams, and David Mann details how endoarterial biopsy provides a new method of assessing pulmonary vascular histology and gene expression in pulmonary arterial hypertension (PAH). Percutaneous pulmonary endoarterial biopsy coupled with histologic and molecular analysis represents a potential new paradigm for diagnosis and potential treatment of PAH. Histomolecular analysis could become a routine component of the diagnostic information obtained in patients with pulmonary vascular diseases at the time of cardiac catheterization. In addition to obtaining pressures, cardiac output, calculation of pulmonary vascular resistance, angiography and vasodilator testing, endoarterial biopsy with histologic and molecular analysis would add a whole new dimension of biologic information to aid in diagnosis and choice of therapy. This analysis could identify novel applications for existing and new PAH drugs. The detection of stage- and disease-specific variation in gene expression could lead to individualized therapies.