Litvack F, Grundfest W S, Lee M E, Carroll R M, Foran R, Chaux A, Berci G, Rose H B, Matloff J M, Forrester J S
Clin Cardiol. 1985 Feb;8(2):65-70. doi: 10.1002/clc.4960080202.
The purpose of this study is to describe the use of angioscopes in flowing bloodstreams of animals and humans, to demonstrate the ability to precisely deliver laser energy to an intravascular target using visual guidance and to determine the information content and spatial content of angioscopy. Angioscopy was performed in 5 living dogs, 16 cadaver vascular segments, and 14 patients at the time of peripheral or coronary bypass surgery. Five canine femoral artery segments received angioscopically directed intravascular Nd:YAG laser irradiation. We were able to precisely direct the laser irradiation to predetermined intimal targets. Gross tissue injury varied from none to carbonization and vascular perforation, depending on incident energy. Using a variety of flexible fiberoptic endoscopes ranging in diameter from 1.5 to 3.7 mm, we were able to visualize intravascular structures including plaque, suture lines, venous valves, and thrombi in living patients. No patient incurred complications of any sort. We conclude that angioscopy using flexible endoscopes can be performed safely, can provide clinically useful information, and may provide a means for delivering visually directed intravascular laser irradiation.
本研究的目的是描述血管镜在动物和人类血流中的应用，证明使用视觉引导将激光能量精确输送至血管内目标的能力，并确定血管镜检查的信息内容和空间内容。在5只活体犬、16个尸体血管段以及14例接受外周或冠状动脉搭桥手术的患者身上进行了血管镜检查。对5个犬股动脉段进行了血管镜引导下的血管内Nd:YAG激光照射。我们能够将激光照射精确地导向预定的内膜靶点。根据入射能量的不同，组织大体损伤程度从无到碳化及血管穿孔不等。使用直径从1.5至3.7毫米的各种柔性纤维内镜，我们能够在活体患者中观察到血管内结构，包括斑块、缝线、静脉瓣膜和血栓。没有患者发生任何类型的并发症。我们得出结论，使用柔性内镜进行血管镜检查可以安全地进行，能够提供临床有用信息，并且可能为进行视觉引导的血管内激光照射提供一种手段。
