Hombach V, Höher M, Höpp H W, Kochs M, Eggeling T, Hannekum A, Hügel W, Hilger H H
Abteilung Innere Medizin IV, Universität Ulm, Federal Republic of Germany.
Surg Endosc. 1988;2(1):1-4. doi: 10.1007/BF00591390.
The feasibility and safety of coronary endoscopy was evaluated in three sets of investigations: in 7 cadaver hearts, in 11 patients undergoing coronary bypass surgery, and in 30 patients during routine cardiac catheterization prior to coronary balloon angioplasty (PTCA). In three of the seven cadaver hearts the lumen of the arteries appeared normal. In three diffuse atherosclerotic lesions, and in one, a high-grade, tight stenosis were observed. In nine of eleven patients in the operation room, the lesions of interest could be visualized, and high-grade stenoses were found in all. In addition, in three patients with unstable angina pectoris, fresh thrombi were seen at the site of stenosis. In six of the nine patients, the periphery of the native coronary vessel was found to have no further stenotic regions. During cardiac catheterization in 17/30 patients, the lesion of interest could be examined angioscopically, and in 13 instances the stenosis appeared excentric and irregularly shaped. In three instances, multiple ulcerations were seen in the stenotic area. In two of the five patients, intimal ruptures were found following PTCA, which could not be documented angiographically. Coronary endoscopy provides valuable additional information on the nature and appearance of atherosclerotic lesions. It can be performed clinically without great harm to the patients. Despite some limitations, it will probably become a routine diagnostic tool in patients undergoing routine coronary angiography, balloon angioplasty or high-frequency angioplasty, and coronary bypass grafting.
对7个尸体心脏、11例接受冠状动脉搭桥手术的患者以及30例在冠状动脉球囊血管成形术（PTCA）前进行常规心导管检查的患者进行了研究。在7个尸体心脏中的3个中，动脉腔看起来正常。在3个中观察到弥漫性动脉粥样硬化病变，在1个中观察到高度、严重狭窄。在手术室的11例患者中的9例中，可以看到感兴趣的病变，并且均发现了高度狭窄。此外，在3例不稳定型心绞痛患者中，在狭窄部位看到了新鲜血栓。在9例患者中的6例中，发现原生冠状动脉血管周围没有进一步的狭窄区域。在30例患者中的17例进行心导管检查期间，可以通过血管内镜检查感兴趣的病变，在13例中，狭窄呈偏心且形状不规则。在3例中，在狭窄区域看到多个溃疡。在5例患者中的2例中，在PTCA后发现内膜破裂，血管造影无法记录。冠状动脉内镜检查提供了有关动脉粥样硬化病变性质和外观的有价值的额外信息。它可以在临床上进行，对患者没有太大伤害。尽管有一些局限性，但它可能会成为接受常规冠状动脉造影、球囊血管成形术或高频血管成形术以及冠状动脉搭桥术患者的常规诊断工具。
