Abstract
Since we introduced angioscopy in autumn 1991 by in situ vein bypass operations we have used four different angioscopes with outer diameters
of 2.2, 2.3, 2.8, and 2.9 mm. The 2.2 mm model was steerable, and collateral irrigation
through a separate irrigation catheter was used. The other scopes had a built-in irrigation
channel. Irrigation fluid was provided by a pressure cuff device placed around a liter
of Ringer's acetate solution in plastic bag and inflated to between 200 and 300 mmHg.
Recently we have used a roller pump that provides adjustment of the flow rate with
a constant pressure of 200 mmHg. A Mills valve cutter was tested in the initial phase,
but later the Insitucath proved more suitable. Valve disruption has been safe and
confident. In addition, the angioscopy has been used as an adjuvant method in carotid
endartectomies, thromboembolectomies, aortobifemoral reconstructions, iliacofemoral
endarterectomies, in vascular access surgery, and percutaneous stent application.
The visualization has been excellent or good and there have not been any significant
complications due to the angioscopes. The use of angioscopy is well established in
our arterial procedures and in the near future it will be introduced in venous surgery.
The need for further studies concerning the significance of intraluminal findings
is obvious.
