Mizuno K, Miyamoto A, Isojima K, Kurita A, Senoo A, Arai T, Kikuchi M, Nakamura H
Department of Emergency Medicine, National Defense Medical College, Saitama, Japan.
Angiology. 1992 Feb;43(2):91-9. doi: 10.1177/000331979204300202.
This study was undertaken to observe coronary thrombus formation serially from an antegrade perspective by means of a new thin flexible angioscope that has an inflatable balloon at the distal tip and an angulation mechanism. To test its capabilities, thrombi were induced in the left anterior descending coronary artery of 11 dogs by copper coils, and the thrombi were then observed through this angioscope, which had been introduced into the coronary artery by a guide catheter. Five minutes after insertion of the copper coil, fibrin-like material and white components of the thrombi were seen massing around the copper coil. Then, thin, mixed thrombotic white and red components formed around the copper coil. At fifteen minutes after the copper coil insertion, the thrombi grew in size. Ten minutes later, the thrombi finally obstructed the coronary lumen in most dogs. The red and white appearance of these thrombi was confirmed macroscopically, and the microscopic findings of these occluding thrombi revealed a fibrinous network with platelet aggregates and blood cell coagulation. Though ordinary angiography cannot reveal the precise features of the various coronary thrombi, this new angioscope was able to discern them from the antegrade perspective. The capabilities of this angioscope, which enabled these findings, should prove helpful in evaluating the stages of human coronary thrombosis. Of additional benefit, this angioscope can be used clinically for cardiac catheterization.
本研究旨在通过一种新型细柔性血管镜从顺行角度连续观察冠状动脉血栓形成情况，该血管镜在远端有一个可充气气球和一个成角机制。为测试其性能，通过铜线圈在11只犬的左前降支冠状动脉中诱导血栓形成，然后通过经引导导管引入冠状动脉的该血管镜观察血栓。插入铜线圈5分钟后，可见纤维蛋白样物质和血栓的白色成分聚集在铜线圈周围。然后铜线圈周围形成薄的、混合的白色和红色血栓成分。插入铜线圈15分钟后，血栓体积增大。10分钟后，大多数犬的血栓最终阻塞冠状动脉管腔。肉眼证实了这些血栓的红白外观，这些阻塞性血栓的显微镜检查结果显示为有血小板聚集和血细胞凝固的纤维网络。虽然普通血管造影无法显示各种冠状动脉血栓的精确特征，但这种新型血管镜能够从顺行角度辨别它们。这种血管镜的这些性能在评估人类冠状动脉血栓形成阶段方面应会有所帮助。另外，这种血管镜可临床用于心脏导管插入术。
