We performed angioscopy on 31 patients with suspected chronic pulmonary arterial ob-struction using three prototype angioscopes. The instruments varied in length (80, 90, and 120 cm), outside diameter (3.2 and 4 mm), and distal tip deflection (70, 90, and 180 degrees). All had a distal viewing balloon. Conventional diagnostic studies were performed and decisions about diagnosis and operability were made prior to angioscopy. An independent assessment of diagnosis and operability was then made based on the results of angioscopy. Surgical confirmation was obtained in most cases and clinical or autopsy data were obtained in the remainder. Angioscopy led to a change in the diagnosis of 6 patients (19%). Four of 25 patients with chronic pulmonary emboli were felt to be inoperable based on the angioscopic findings. Two of these 4 underwent surgery and were found to be inoperable. 21 of the remaining 25 patients were felt to have operable disease and 19 underwent surgery. In 14 of these 19 (74%), the conventional studies were either negative or equivocal with respect to operability and the decision to operate was based on angioscopic data. We conclude that good visualization of the central pulmonary arteries can be achieved with the optical balloon technique; that the procedure can be performed safely in patients with severe pulmonary hypertension; and that the information obtained by angioscopy can significantly affect clinical decisions in patients with chronic pulmonary artery obstruction.
"Pulmonary Vascular Angioscopy - Current Results", Proc. SPIE 0906, Optical Fibers in Medicine III, (21 June 1988); doi: 10.1117/12.945259; https://doi.org/10.1117/12.945259