AN ANGIOSCOPIC METHOD FOR INTRALUMINAL AORTIC EVALUATION AND STENT PLACEMENT

Purpose: The purpose of this study was to develop an angioscopic techn ique to visualize the endoluminal surface of the aorta and to guide va scular stent placement. Methods: A fiberoptic angioscope, fitted with a balloon at its tip, was passed via a carotid arteriotomy into the ab dominal aorta of seven anesthetized pigs. Saline solution inflation of the balloon allowed for blood displacement and clear visualization of the endoluminal anatomy. After the left renal artery orifice had been identified with angioscopy, a catheter was inserted via a left femora l sheath to cannulate the orifice under direct visualization. The posi tion of the catheter was verified angiographically. A vascular stent w as loaded onto an angioplasty balloon, inserted through a right femora l arteriotomy, positioned by use of angioscopic visualization, and dep loyed immediately below the left renal artery orifice. Results: The ao rtic trifurcation and the lumbar and renal artery orifices were clearl y visualized in every animal. Vascular stents were placed in seven ani mals within an average of 3.14 +/- 1.14 mm (mean +/- SEM, range 0 to 8 mm) below the inferior rim of the left renal artery orifice. No stent s were positioned above a renal artery orifice or obstructed blood flo w. Conclusions: This angioscopic technique permitted detailed evaluati on of aortic endoluminal anatomy and precise implantation of vascular stents. Direct endovascular visualization may facilitate other endovas cular procedures, including endovascular grafting.