Abstract
In the mid 80’s, Spears et al and Litvack et al(2) reported the use of large diameter (1.8–3.3 mm) endoscopes to visualize the surface of peripheral and coronary blood vessels during surgery. In the last five years, major improvements in fiberoptic technology have made it possible to perform percutaneous coronary and peripheral vascular imaging in the catheterization laboratory. Angioscopy provides unique intravascular information. The interventional cardiologist can determine the etiology of unstable coronary chest pain syndromes, assess the trauma created by angioplasty, determine the appropriateness of stent placement, and evaluate the completeness of thrombolysis. Vascular surgeons can inspect anastomoses and determine the completeness of thrombectomy. Despite the unique vascular detail provided to coronary interventionists by angioscopy, it probably will not evolve into routine use, because catheterization labo ratory decisions rarely depend on such information. Conversely angioscopy continues to have great value in clinical coronary research, and is widely used by peripheral vascular surgeons for intraoperative decisionmaking.
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References
Surg 1994; Spears JR, Spokojny AM, Marais HJ. Coronary angioscopy during cardiac catheterization. JACC 1985; 6:93–7.
Litvack IF, Grundfest W, Lee ME, Carroll RN, Foran R, Chaux A, Berci G, Rose HB, Matloff JM, Forrester JS. Angioscopic examination of blood vessel interior in animals and humans. Clin Card 1985; 8:65–70.
Katzir A. Optical Fibers in Medicine. Sci Am 1989; 120–125.
Auth D, Physical principles and limitations of fiberoptic angioscopy in Endovascular Surgery 1989; W. B. Saunders and Co., ed Moore WS and Ahn SS, 31–38.
Franzen D, Hopp HW, Korsten J, Hilger HH. A prospective study on percutaneous coronary angioscopy with different guiding techniques in patients with coronary heart disease. Eur Heart J 1992; 13:655–660.
Sherman CT, Utvack F, Grundfest W, Lee M, Hickey A, Chaux A, Kass R, Blanche C, Matloff J, Morgenstem L, Ganz W, Swan HJC, Forrester J: Demonstration of thrombus and complex atheroma by in-vivo angioscopy in patients with unstable angina pectoris. NEJM 315:913–919, 1986.
Forrester J, Litvack F, Grundfest W, Segalowitz J, Hickey A. Sympo sium: intravascular imaging and flow: Cardiac angioscopy in acute ischemic syndromes. Amer J of Cardiac Imaging 1988; 2:178–184.
den Heijer P, Foley DP, Hillege HL, Lablanche JM. The ‘Ermonville classification of observations at coronary angioscopy—evaluation of intra and inter-observer agreement. European Working Group on Coronary Angioscopy. Eur Heart J 1994; 15:815–22.
Siegel RJ, Ariani M, Fishbein MC, Chae JS et al. Histopathologic valida tion of angioscopy and intravascular ultrasound. Circulation 1991; 84:109–17.
Schwartz A, Burrig KF, Aulich A. Usefulness of angioscopy in stenotic processes of the carotid — a comparison with morphological findings. Endoscopy 1988; 20:107–110.
Van Stiegman G, Perace W, Bartie E et al. Flexible angiscopy seems faster and more specific than arteriography. Arch Surg 1987; 122:279–283.
Johnson C, Hansen D, Vracko R, Ritchie J. Angiscopy-more sensitive for identifying thrombus, distal emboli, and subintimal dissection. J Am Coll Cardiol 1989; 13:146A.
den Heijer P, Foley DR, Escaned J, Hillege HL. Angioscopic versus angiographic detection of intimal dissection and intracoronary thrombus. JACC 1994; 24:649–54.
Mizuno K, Yanagida. T, Shibuya T, Arakawa K. The effectiveness of coronary angioscopy in detecting intraluminal pathologic changes. Jpn Circ J 1992; 56:586–91.
Uretsky BF, Denys BG, Counihan PC, Ragosta M. Angioscopic evalua tion of incompletely obstructing coronary intraluminal filling defects; com parison of angiography. Cathet Cardiovasc Diagn 1994; 33:323–9.
Spears JR, Ali M, Raza SJ, Iyer GS. Quantitative angioscopy: A novel method of measurement of luminal dimensions during angioscopy with the use of a lightwire. Cardiovasc Intervent Radiol 1994; 17:197–203.
Lee G, Garcia J, Corso P, Chan M, Rink J, Pichard A, Lee K, Reis R, Mason D. Correlation of coronary angioscopic to angiographic findings in coronary artery disease. ACC 1986; 57:238–241.
Schuurbiers JC, Slager CJ, Serruys PW. Luminal volume reconstruction from angiscopic video images of casts from human coronary arteries. Am J Cardiol 1994; 78:764–8.
Mizuno K, Miyamoto A, Satomura K, Kurita A et al. Angioscopic coronary macromorphology in patients with acute coronary disorders. Lancet 1991; 337:809–12.
White CJ, Ramee SR, Collins TJ, Mesa JE, Jain A. Percutaneous an gioscopy of saphenous vein coronary bypass grafts. J Am Coll Cardiol 1993; 21:1181–5.
Mizuno K, Satomura K, Miyamoto A, Arakawa K et al. Angioscopic evaluation of coronary artery thrombi in acute coronary syndromes. New Engl Journal of Medicine 1992; 326:287–91.
Uchida Y, Nakamura F, Tomaru T, Sonoki H, Sumino S, Sugimoto T. Angiographic and angioscopic observations of the arterial luminal changes induced by vasospasm. Am Heart J 1987; 114:1096–1101.
Uchida Y, Hasegawa K, Kawamura K, Shibuya I. Angiocopic observation of the coronary luminal changes induced by percutaneous transluminal coronary angioplasty. Am Heart J 1989; 117:769–776.
den Heijer P, van Dijk RB, Hillege HL, Pentinga ML. Serial angioscopic and angiographic observations during the first hour after successful coro nary angioplasty: a preamble to a multicenter trial adressing angioscopic markers for restenosis. Am Heart J 1994; 128:656–63.
Barrazet FS, Dupouy PJ, Rande JL, Hirosaka A. Angioscopy after laser and balloon coronary angioplasty. J Am Coll Cardiol 1994; 23:1321–6.
Nakamura F, Kvasnicka J, Uchida Y, Geschwind HJ. Percutaneous angioscopic evaluation of luminal changes induced by excimer laser an gioplasty, Am Heart J 1992; 124:1467–72.
Ito A, Miyazaki S, Nonogi H, Ozono K, et al. Angioscopic and intravascu lar ultrasound imagings before and after percutaneous holmium-YAG laser coronary angioplasty. Am Heart J 1993; 125:556–8.
Annex BH, Sketch MH Jr, Stack RS, Phillips HR. Transluminal extraction coronary atherectomy. Cardiol Clin 1994; 12:611–22.
Itoh A, Miyazaki S, Nonogi H, Daikoku S, Haze K. Angioscopic prediction of successful dilatation and of restenosis in percutaneous transluminal coronary angioplasty. Significance of yellow plaque. Circ 1995; 81:1389–96.
White CJ, Ramee SR, Mesa JE, Collins TJ. Percutaneous coronary angioscopy in patients with restenosis after coronary angioplasty. J Am Coll Cardiol 1991; 17:46b–49b.
Teirstein PS, Schatz RA, Wong SC, Rocha-Singh KJ. Coronary stenting with angioscopic guidance. Am J Cardiol 1995; 75:344–7.
Strumpf RK, Heuser RR, Eagan JT Jr. Angioscopy: a valuable tool in the deployment and evaluation of intracoronary stents. Am Heart J 1993; 126:1204–10.
den Heijer P, van Dijk RB, Twisk SP, Lie K. Early stent occlusion is not always caused by thrombosis. Cathet Cardiovasc Diagn 1993; 29:136–40.
Resar JR, Blinker J. Early coronary artery stent restenosis! utility of percutaneous coronary angioscopy. Cathet Cadiovasc Diag 1992; 27:276–9.
Ueda Y, Nanto S, Komamura K, Kodama K. Neointimal coverage of stents in human coronary arteries observed by angioscopy. J Am Coll Cardiol 1994; 23:341–6.
Bessou JP, Melki J, Bouchart F, Mouton-Schleifer D, et al. Intraoperative coronary angioscopy-technique and results: a study of 38 patients. J Card Surg 1993; 8:483–7.
White GH, Siegel SB, Colman PD, Kopchok GE, White RA. Intraopera tive coronary angioscopy: development of practical techniques. Angiology 1990; 41:793–800.
Grundfest W, Litvack F, Glick D, Segalowitz J, Treiman R, Cohen L, Foran R, Levin P, Cossman D, Carroll R, Spigelman A, Forrester J, Circ 1988; 78:3.
Dietrich EB, Yoffe B, Kiessling JJ, Santiago O, et al. Angioscopy in en dovascular surgery: recent technical advances to ehance intervention selection and failure analysis. Angiology 1992; 43:1–10.
Hofling G, Polnita A, Bauriedel G, Backa D, Lauterjung L, Simpson J. Use of angioscopy to assess the results of percutaneous atherectomy. Am J Cardiac Imaging 1989; 3:20–26.
Trubel W, Magoometschnigg H, al-Hachich Y, Staudacher M. Intraopera tive control following femorodistal revascularization: angioscopy is supe rior to angiography. Thorac Cardiovasc 42:199–207.
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Forrester, J.S., Litvack, F., Eigler, N., Siegel, R.J. (1997). Defining Coronary Pathology and Clinical Syndromes by Coronary Angioscopy. In: Klein, L.W. (eds) Coronary Stenosis Morphology: Analysis and Implication. Developments in Cardiovascular Medicine, vol 190. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-6287-0_9
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