Wendt T, Bettinger R, Kober G
Klinikum der Universität Frankfurt, Zentrum der Inneren Medizin, Abteilung Kardiologie.
Versicherungsmedizin. 1990 Jun 1;42(3):83-8.
Direct visual examination of the interior surfaces of intact human coronary arteries is now a reality, both from intraoperative and transluminal approaches. As an additional investigation to angiography it improves the knowledge about the corresponding morphology of angiographically visible changes. Since the first report about percutaneous and intraoperative coronary angioscopy by Spears et al. in 1982 important indications concerning the intraoperative approach were defined such as the control of coronary atherectomy, intraoperative balloon dilatation and laser angioplasty, the inspection of the grafts prior to implantation and the assessment of the quality of the distal anastomosis after graft insertion. The most important clinical result angioscopy has brought about is the postulation of a concept of the different clinical forms of coronary artery disease based on the morphological stages of atherosclerosis, which were defined by angioscopy and could be related to clinical symptoms. Scientific studies today are concerned with determinants for the patency rate of bypasses, the restenosis rate of PTCA, the acute and chronic effects of drugs, and the mechanism of all kinds of catheter-supported angioplasties. The next important application of coronary angioscopy will undoubtedly be the simultaneous visual control of coronary angioplasty procedures such as laser angioplasty and other new methods.
现在，无论是通过术中还是腔内途径，直接目视检查完整人体冠状动脉的内表面已成为现实。作为血管造影的一项补充检查，它增进了我们对血管造影可见变化相应形态的了解。自1982年 Spears 等人首次报道经皮和术中冠状动脉血管镜检查以来，术中检查的重要指征得以明确，如冠状动脉斑块旋切术、术中球囊扩张术和激光血管成形术的控制，移植前移植物的检查以及移植后远端吻合口质量的评估。血管镜检查带来的最重要临床成果是基于动脉粥样硬化形态学阶段提出了冠状动脉疾病不同临床形式的概念，这些阶段由血管镜检查定义并可与临床症状相关联。如今的科学研究关注旁路通畅率的决定因素、经皮冠状动脉腔内血管成形术（PTCA）的再狭窄率、药物的急性和慢性影响以及各种导管辅助血管成形术的机制。冠状动脉血管镜检查的下一个重要应用无疑将是对冠状动脉血管成形术（如激光血管成形术和其他新方法）进行同步视觉控制。
