Angioscopy and ischemic heart disease

Abstract

Angioscopy allows direct visualization of the coronary artery lumen and provides detailed information regarding the surface characteristics of the vessel wall and specific lesions causing acute coronary syndromes. Disruption of a plaque, ulceration, tears, fissures, lipid-rich or fibrous lesions, and luminal or mural thrombus can be readily detected in vivo. Characterization of culprit lesions in various coronary syndromes reveals the different mechanisms of ischemia. The predominant lesion in acute myocardial infarction is an ulcerated, yellow plaque with thrombus. In unstable angina, different substrates can be seen, from the lipid-rich lesion with thrombus to the fibrous smooth plaque, reflecting a varied physiopathology. Because of its ability to detect superficial lipid pools, angioscopy may be valuable for the detection of vulnerable plaques.

Spectral-domain spectrally-encoded endoscopy

“…Fetal and pediatric procedures could benefit from this tool as well, including fetoscopy, fetoscopic surgery, and pediatric surgery. [6,24,25] The effectiveness of recently introduced minimally invasive techniques, such as mammary ductoscopy, [3,4] neuroendoscopy, [26] microendoscopic discectomy [27] and coronary angioscopy, [2,28] may also be greatly improved by the introduction of flexible, 3D imaging probes with small diameters.…”

Multiple-channel spectrally encoded imaging

“…Since the mid-80's, the remarkable progress in fiber optics and photonics technologies have opened new opportunities for imaging inside the body through more compact endoscopic instruments, owing to the small diameter and flexibility of silica optical fibers. Fiber bundle endoscopes [1][2][3][4] have made a considerable impact in clinical applications such as ductoscopy [5,6], embryoscopy [7], and angioscopy [8] which require imaging through small diameter probes. The use of a single optical fiber and a scanning mechanism at the distal end of an endoscope [9][10][11] eliminate pixelation artifacts and improve probe flexibility, at the expense, however, of the bulk of the mechanical scanning apparatus at the distal end of the endoscope.…”