Seeger J M, Abela G S
J Vasc Surg. 1986 Oct;4(4):315-20.
To date our use of angioscopy as an adjunct to in situ vein grafting, arterial embolectomy, femoropopliteal bypass surgery, and laser recanalization has been studied in 11 patients. Three angioscopes have been used: a 1.7 mm optiscope, a 2.8 mm laser optiscope, and a 3.2 mm bronchoscope. Scopes were introduced through an arteriotomy and a clear field maintained by continuous saline infusion. Twenty-four angioscopic evaluations were performed in the 14 patients studied. Adequate visualization was achieved with all three scopes. Angioscopy showed total atherosclerotic occlusion of six superficial femoral and popliteal arteries, intimal flaps in two arteries, thrombus in two arteries and one graft, adequate valvulotomy in three saphenous veins used for in situ bypass grafting, and removal of thrombus after embolectomy in one artery. With the 2.8 mm laser optiscope, the optical fiber used for laser recanalization could be positioned at the site of arterial occlusion before lasing and recanalization were done under direct vision. The 1.7 mm scope could be passed through the recanalized artery to inspect the channel and confirm communication with the artery distal to the occlusion. Thus, angioscopy appears to be potentially useful as a diagnostic device in arterial occlusive disease and as an adjunct in in situ saphenous vein grafting or laser recanalization of occluded arterial segments.
迄今为止，我们已对11例患者使用血管内镜辅助原位静脉移植、动脉栓子切除术、股腘动脉搭桥手术及激光再通术进行了研究。我们使用了三种血管内镜：一种1.7毫米的光学内镜、一种2.8毫米的激光光学内镜及一种3.2毫米的支气管镜。通过动脉切开术插入内镜，并通过持续输注生理盐水保持视野清晰。在研究的14例患者中进行了24次血管内镜评估。使用这三种内镜均实现了充分的可视化。血管内镜检查显示，六条股浅动脉和腘动脉存在完全动脉粥样硬化闭塞，两条动脉有内膜瓣，两条动脉和一条移植物中有血栓形成，三条用于原位搭桥移植的大隐静脉进行了充分的瓣膜切开术，一条动脉在栓子切除术后清除了血栓。使用2.8毫米激光光学内镜时，可在激光再通前将用于激光再通的光纤置于动脉闭塞部位，并在直视下进行再通。1.7毫米的内镜可穿过再通的动脉以检查通道，并确认与闭塞远端动脉的连通情况。因此，血管内镜似乎有可能作为动脉闭塞性疾病的诊断工具，并作为原位大隐静脉移植或闭塞动脉段激光再通的辅助手段。
