Percutaneous transluminal angioscopy. A new imaging technique for diagnosis of extracranial arterial disease

Angiography and ultrasound techniques are well established methods for the detection of extracranial vascular disease, but they only allow indirect demonstration of changes in the vessel wall. The development of an ultra-thin fiberscope allows direct demonstration of the pathogenic process in the vessel lumina by angioscopy. The percutaneous transfemoral approach for carotid angiography enables the combination of both methods. After development of an appropriate catheter system we investigated the value of this method producing definite lesions by vascular surgery in adult dogs followed by repeated examinations using angioscopy. Vessel wall alterations such as stalagmite-shaped lesions, subintimal bleeding and thrombotic layers, plaques, ulcerations and postoperative intimal bridging or ablation, which could not be identified by angiography have been analysed with high resolution of details using angioscopy with a video monitoring technique.