[The present state of arts and the future prospects of coronary angioscopy]

The angioscope catheter is 1.55 mm in outer diameter and 1.2 m in length. This distal end is tapered, therefore its outer diameter decreased to 1.1 mm. It has an inflatable balloon at the distal tip and four circular channels. Through one of the lumina, 0.014 inch PTCA guide wire can be used. The steerable guide wire enable the angioscope to be inserted to the target lesion safely and accurately. Recently we investigated the appearance of coronary artery in acute coronary syndromes. The results have indicated that thrombi, intimal irregularities, and xanthomatous atheromas were observed more frequently in patients with acute myocardial infarction, recent myocardial infarction and unstable angina. It is concluded that a thrombus overlying a rupture in the lining of plaque plays a major role in an acute coronary disorders, and that the fragile, lipid-rich gruel atheroma may procede its rupture. Coaxial alignments of the coronary artery were obtained in more than 80% of attempted patients. However, a finer controllable distal tip to allow good coaxial alignment and a larger balloon to reduce the coronary good flow and make the angioscopic catheter easier to track, are necessary for more complete visualization.