Departments of Neurosurgery, Univer-sity of Michigan, Ann Arbor, Michigan.
Departments of Radiology, University of Michigan, Ann Arbor, Michigan.
Oper Neurosurg (Hagerstown). 2017 Feb 1;13(1):36-46. doi: 10.1093/ons/opw002.
Angioscopy - or endovascular endoscopy - is a catheter-based technique employing a flexible fiberoptic angioscope to directly visualize arterial lumen. Poor resolution and excessive stiffness of pre-existent angioscopes limited their use clinically. Recent advances resulted in novel fused optical fiber bundle angioscopes with improved flexibility and imaging resolution. Use of these devices in endovascular neurosurgery is still largely unexplored.
To evaluate image quality and feasibility of optical angioscopes for diagnostic and interventional neuro-angioscopy in carotid arteries of human cadavers.
A 5-F optical angioscope was used in human cadaveric carotid arteries to inspect integrity of arterial walls, identify atherosclerotic plaques and associated lesions prone to thrombogenicity, place intravascular occlusion coils, and deploy endovascular stents with real-time visualization.
Angioscopy provided key information about endoluminal anatomy such as presence and characteristics of atherosclerotic plaques and thrombogenic lesions not detected by conventional diagnostic methods. Direct real-time visualization of vascular lumen during endovascular interventions provided information on spatial distribution of coils, coil loop herniation, and apposition of stent cells against carotid artery wall complementary to angiography.
Fused optical fiber bundle angioscopes provide good-quality endoluminal images in human carotid arteries. Their use can feasibly assist in navigation of extracranial carotid arteries to inspect integrity of the arterial wall and identify atherosclerotic plaques and associated lesions vulnerable to thrombogenicity, allow placement of intravascular occlusion coils, and assess apposition of stents to vessel wall. Further in Vivo validation needs to be conducted along with additional research to improve image quality, flexibility, and size of angioscopes.
血管内镜检查——或血管内内镜检查——是一种基于导管的技术，使用柔性纤维光学血管内镜直接观察动脉管腔。先前的血管内镜分辨率差且刚性过大，限制了其在临床上的应用。最近的进展带来了新型融合光纤束血管内镜，其具有更好的柔韧性和成像分辨率。这些设备在血管神经外科学中的应用仍在很大程度上未被探索。
评估光学血管内镜在人类尸体颈动脉的诊断和介入性神经血管镜检查中的图像质量和可行性。
在人类尸体颈动脉中使用 5F 光学血管内镜检查动脉壁的完整性，识别易发生血栓形成的动脉粥样硬化斑块和相关病变，放置血管内闭塞线圈，并使用实时可视化技术部署血管内支架。
血管内镜提供了关于管腔内解剖结构的关键信息，例如动脉粥样硬化斑块和血栓形成病变的存在和特征，这些信息无法通过常规诊断方法检测到。血管内介入期间血管内腔的直接实时可视化提供了有关线圈空间分布、线圈环疝出以及支架细胞与颈动脉壁贴合情况的信息，这些信息与血管造影互补。
融合光纤束血管内镜在人类颈动脉中提供高质量的管腔内图像。它们的使用可以辅助颅外颈动脉的导航，检查动脉壁的完整性，识别易发生血栓形成的动脉粥样硬化斑块和相关病变，允许放置血管内闭塞线圈，并评估支架与血管壁的贴合情况。需要进一步进行体内验证，并进行额外的研究以提高血管内镜的图像质量、柔韧性和尺寸。
