Coronary angioscopy

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Coronary angioscopy is the current gold standard for the detection of intracoronary thrombus. In comparison with angioscopy; number of clinical studies have been reported the lack of sensitivity of coronary angiography to detect a coronary thrombus. [1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] [15] [16] [17] [18] [19]


Clinical use

  • Helpful tool to estimate plaque wall thickness
  • High resolution (10–50 μm)
  • Obtains good surface imaging (i.e., thrombus, color)
  • Provides forward viewing

Types of equipment

Two types of modalities are available. A forward looking camera and a side looking camera.

Disadvantages

  • May cause vascular damage
  • Needs blood displacement

References

  1. den Heijer P, Foley DP, Escaned J, et al. Angioscopic versus angiographic detection of intimal dissection and intracoronary thrombus. J Am Coll Cardiol 1994;24: 649–654.
  2. Teirstein PS, Schatz RA, DeNardo SJ, et al. Angioscopic versus angiographic detection of thrombus during coronary interventional procedures. Am J Cardiol 1995;75: 1083–1087.
  3. Uretsky B, Denys B, Counihan P, et al. Angioscopic evaluation of incompletely obstructing coronary intraluminal filling defects: Comparison to angiography. Cathet Cardiovasc Diagn 1994;33: 323.
  4. Mizuno K, Satomura K, Miyamoto A, et al. Angioscopic evaluation of coronary-artery thrombi in acute coronary syndromes. New Engl J Med 1992;326: 287–291.
  5. Lehmann KG, van Suylen RJ, Stibbe J, et al. Composition of human thrombus assessed by quantitative colorimetric angioscopic analysis. Circulation 1997;96: 3030–3041.
  6. Maeng M, den Heijer P, Olesen PG, et al. Histologic validation of in-vivo angioscopic observation of coronary thrombus after angioplasty in a porcine model. Coron Artery Dis 2001;12: 53–59.
  7. Abela GS, Eisenberg JD, Mittleman MA, et al. Detecting and differentiating white from red coronary thrombus by angiography in angina pectoris and in acute myocardial infarction. Am J Cardiol 1999;83: 94–97.
  8. Siegel RJ, Ariani M, Fishbein M, et al. Histopathologic validation of angioscopy and intravascular ultrasound. Circulation 1991;84: 109–117.
  9. Waxman S, Mittleman MA, Zarich SW, et al. Plaque disruption and thrombus in Ambrose's angiographic coronary lesion types. Am J Cardiol 2003;92: 16–20.
  10. Sherman CT, Litvack F, Grundfest W, et al. Coronary angioscopy in patients with unstable angina pectoris. N Engl J Med 1986;315: 913–919.
  11. Mizuno K, Miyamoto A, Satomura K, et al. Angioscopic coronary macromorphology in patients with acute coronary disorders. Lancet 1991;337: 809–812.
  12. Davies MJ, Thomas A. Thrombosis and acute coronary artery lesions in sudden cardiac ischemic death. N Engl J Med 1984;310: 1137–1140.
  13. DeWood MA, Spores J, Notske R, et al. Prevalence of total coronary occlusion during the early hours of transmural myocardial infarction. N Engl J Med 1980;303: 897–902.
  14. Tabata H, Mizuno K, Arakawa K, et al. Angioscopic identification of coronary thrombus in patients with postinfarction angina. J Am Coll Cardiol 1995;25: 1282–1285
  15. Alfonso F, Segovia J, Goicolea J, et al. Angioscopic characteristics of coronary narrowing in patients with recurrent myocardial ischemia after myocardial infarction. Am J Cardiol 1997;79: 1394–1396.
  16. Van Belle E, Lablanche JM, Bauters C, et al. Coronary angioscopic findings in the infarct-related vessel within 1 month of acute myocardial infarction: Natural history and the effect of thrombolysis. Circulation 1998;97: 26–33.
  17. Ueda Y, Asakura M, Yamaguchi O, et al. The healing process of infarct-related plaques. Insights from 18 months of serial angioscopic follow-up. J Am Coll Cardiol 2001;38: 1916–1922.
  18. de Feyter PJ, Ozaki Y, Baptista J, et al. Ischemia-related lesion characteristics in patients with stable or unstable angina. A study with intracoronary angioscopy and ultrasound. Circulation 1995;92: 1408–1413.
  19. Silva, J. A., Escobar, A., Collins, T. J., Ramee, S. R., White, C. J.. Unstable Angina : A Comparison of Angioscopic Findings Between Diabetic and Nondiabetic Patients. Circulation 1995. 92: 1731-1736

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