Shure D, Gregoratos G, Moser K M
Ann Intern Med. 1985 Dec;103(6 ( Pt 1)):844-50. doi: 10.7326/0003-4819-103-6-844.
We evaluated the role of fiberoptic angioscopy in eight patients with suspected chronic pulmonary embolic obstruction of the pulmonary arteries. Angioscopy, preceded by ventilation-perfusion lung scans, right-heart catheterization, and pulmonary angiography, resulted in diagnostic changes in four patients: from pulmonary artery agenesis to chronic emboli; from chronic emboli to normal pulmonary arterial intima (primary pulmonary hypertension); from chronic pulmonary emboli to extrinsic compression of a major pulmonary artery (fibrosing mediastinitis); and from suspected agenesis or chronic emboli to a tumor (fibrosarcoma) of the pulmonary artery. Angioscopy also more accurately determined the extent and surgical accessibility of chronic embolic obstruction in the five patients with that disorder; as a result, we decided that the obstruction in one patient was inoperable. No significant complications occurred with angioscopy and we conclude that its direct visualization capability can contribute significantly to the diagnostic evaluation of suspected chronic pulmonary arterial obstruction.
我们评估了纤维光学血管镜在8例疑似慢性肺动脉栓塞性阻塞患者中的作用。血管镜检查在通气-灌注肺扫描、右心导管检查和肺动脉造影之后进行，结果使4例患者的诊断发生了改变：从肺动脉发育不全变为慢性栓子；从慢性栓子变为正常肺动脉内膜（原发性肺动脉高压）；从慢性肺栓塞变为主要肺动脉的外部压迫（纤维性纵隔炎）；从疑似发育不全或慢性栓子变为肺动脉肿瘤（纤维肉瘤）。血管镜检查还更准确地确定了5例患有该疾病患者慢性栓塞性阻塞的范围和手术可及性；因此，我们判定1例患者的阻塞无法手术治疗。血管镜检查未发生明显并发症，我们得出结论，其直接可视化能力可为疑似慢性肺动脉阻塞的诊断评估做出重大贡献。
