Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.
Vena Medical Inc, Waterloo, Ontario, Canada.
J Neurointerv Surg. 2019 Oct;11(10):1036-1039. doi: 10.1136/neurintsurg-2018-014610. Epub 2019 Mar 16.
Endovascular technological advances have revolutionized the field of neurovascular surgery and have become the mainstay of treatment for many cerebrovascular pathologies. Digital subtraction angiography (DSA) is the 'gold standard' for visualization of the vasculature and deployment of endovascular devices. Nonetheless, with recent technological advances in optics, angioscopy has emerged as a potentially important adjunct to DSA. Angioscopy can offer direct visualization of the intracranial vasculature, and direct observation and inspection of device deployment. However, previous iterations of this technology have not been sufficiently miniaturized or practical for modern neurointerventional practice.
To describe the evolution, development, and design of a microangioscope that offers both high-quality direct visualization and the miniaturization necessary to navigate in the small intracranial vessels and provide examples of its potential applications in the diagnosis and treatment of cerebrovascular pathologies using an in vivo porcine model.
In this proof-of-concept study we introduce a novel microangioscope, designed from coherent fiber bundle technology. The microangioscope is smaller than any previously described angioscope, at 1.7 F, while maintaining high-resolution images. A porcine model is used to demonstrate the resolution of the images in vivo.
Video recordings of the microangioscope show the versatility of the camera mounted on different microcatheters and its ability to navigate external carotid artery branches. The microangioscope is also shown to be able to resolve the subtle differences between red and white thrombi in a porcine model.
A new microangioscope, based on miniaturized fiber optic technology, offers a potentially revolutionary way to visualize the intracranial vascular space.
血管内技术的进步彻底改变了神经血管外科学领域，已成为许多脑血管病变治疗的主要手段。数字减影血管造影（DSA）是血管可视化和血管内器械部署的“金标准”。尽管如此，随着光学技术的最新进展，血管内窥镜检查已成为 DSA 的重要辅助手段。血管内窥镜检查可以提供颅内血管的直接可视化，并直接观察和检查器械的部署情况。然而，这项技术的早期迭代在尺寸或实用性方面还不够完善，无法满足现代神经介入治疗的需要。
描述一种微型血管镜的发展历程，这种血管镜提供了高质量的直接可视化，并且足够小巧，可以在颅内小血管中进行导航，并通过活体猪模型展示其在脑血管病变诊断和治疗中的潜在应用。
在这项概念验证研究中，我们引入了一种新型微型血管镜，采用相干光纤束技术设计。该微型血管镜的尺寸比以前描述的任何血管镜都要小，只有 1.7 F，同时保持高分辨率的图像。利用猪模型在体内演示了图像的分辨率。
微型血管镜的视频记录显示了安装在不同微导管上的摄像头的多功能性及其在颈外动脉分支内导航的能力。还展示了微型血管镜能够分辨猪模型中红血栓和白血栓之间的细微差异。
一种基于微型光纤技术的新型微型血管镜提供了一种可视化颅内血管空间的潜在革命性方法。
