Abstract
Angioscopy is a new diagnostic tool that permit non-operative imaging of intravascular structure. However, the efficacy of angioscopy has not be defined. Therefore, we investigated the strength and weakness of angioscopy for the diagnosis of intraluminal changes, compared with intravascular ultrasound. We also evaluated the efficacy of angioscopy during laser angioplasty and thrombolytic therapy. Finally, we evaluated whether coronary angioscopy can predict adverse outcomes such as sudden death, or acute myocardial infarction. I. The strength and weakness of angioscopy: Both angioscopy and intravascular ultrasound were performed using 27 postmortem human arterial segment. Angioscopy was much more sensitive in detecting thrombus, complex atheroma, and yellow atheroma than intravascular ultrasound. II. The efficacy of angioscopy during intervention: (1) Laser angioplasty. Using the torc control and the angulation mechanism of the angioscopic catheter, all target lesions were placed to the good position for laser irradiation. Nine out of 11 laser angioplasty were succeeded without perforation. (2) Thrombolytic therapy. Angioscopy could define the character of coronary thrombi (e. q. red thrombi, white thrombi) and angioscopy revealed the efficacy of thrombolytic therapy depended on the character of thrombi. White thrombi were more resistant to thrombolytic therapy than red thrombi. III. The prediction of adverse outcomes: Lesion morphology was classified into 4 patterns by angioscopy. The presence of massive hemorrhage or thrombus is associated with a high proportion of adverse outcomes. Conclusions: Angioscopy is useful for vascular interventions and the prediction of coronary adverse outcomes.
