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At least 19 recordsLinked to original sources

PubMed1991

Thrombolysis by rotational thrombectomy followed by tissue plasminogen activator: evaluation by angioscopy.

Thrombus removal using percutaneous rotational thrombectomy (PRT), followed by tissue plasminogen activator (t-PA), was studied by contrast angiography and fiberoptic angioscopy in a canine femoral artery model of thrombosis. After thrombus induction and following each treatment, comparisons were made between angioscopy and angiography for the detection of thrombus and subintimal dissection. Angioscopic images were scored in a blinded fashion for lining, protruding, or occlusive thrombus (class 1,2, or 3) as well as estimated wall coverage by thrombus. Angiograms were studied for percent diameter stenosis and the presence of flaps. Following external forceps crush injury of 18 arteries, two hour occlusion, and injection of thrombin, mean angiographic stenosis was 66%, thrombus coverage by angioscopy was 81%, and mean angioscopy class was 2.5. Following PRT, stenosis decreased to 27% (p less than 0.008), thrombus coverage was reduced to 49% (p less than 0.02), and angioscopy class dropped to 2.0 (p less than 0.07). After t-PA treatment, these values were further reduced to 25% (p = NS), 26% (p less than 0.02), and 1.3 (p less than 0.008), respectively. In comparison to angiography, subintimal dissection (seen as flaps) and thrombus (lining, protruding, or occlusive) were present significantly more often by angioscopy (p less than 0.001). It is concluded that PRT results in significant thrombolysis, apparent by angiography and angioscopy. Follow-up t-PA can produce additional, incremental thrombolysis, apparent only by angioscopy. A beneficial role for t-PA following mechanical thrombolysis is suggested by this model. The superior sensitivity of angioscopy for detection of flaps and thrombus is underscored by this study.

Animals↗

PubMed1991

Percutaneous coronary and peripheral angioscopy with saline solution and carbon dioxide gas in porcine and canine arteries.

To obtain a clear view with angioscopy, blood must be displaced. Carbon dioxide (CO2) gas has proved to be a safe intraarterial contrast agent, and it may have advantages over saline solution as an infusion medium for angioscopy. This study compared the use of CO2 gas and saline solution in the femoral artery, in the presence and absence of a proximal occlusion, in nine pigs and six dogs. The applicability of CO2 gas in the coronary arteries was also evaluated. In total 185 angioscopy procedures were evaluated. With proximal occlusion, angioscopy with CO2 gas was successful in all 28 peripheral procedures, whereas with saline solution only 65% of the procedures resulted in a clear view (p less than 0.005). Without proximal occlusion, angioscopy was successful with CO2 gas and saline solution in 61% and 3% of procedures, respectively (p less than 0.0001). Cardiovascular parameters and blood gases showed minor changes after administration of CO2 gas. During coronary angioscopy with CO2 gas, mechanical heart failure occurred in all instances, which was lethal in 12 animals. None of the animals died as a result of saline angioscopy. In conclusion, CO2 gas is a safe medium for angioscopy in the peripheral arteries and in general offers a better view than saline solution. In contrast to saline solution, without proximal balloon occlusion CO2 gas provided a clear view in 61% of the peripheral procedures. In the coronary arteries, however, CO2 angioscopy was generally fatal in both animal models.

Animals↗

PubMed1991

Endovascular management of arterial intimal defects: an experimental comparison by arteriography, angioscopy, and intravascular ultrasonography.

To determine the feasibility of the endovascular management of intimal defects while comparing the accuracy of arteriography with angioscopy and intravascular ultrasonography, we developed an in vivo model of arterial intimal flaps. In 10 superficial femoral arteries of five anesthetized mongrel dogs, intimal flaps were constructed and then imaged by arteriography, angioscopy, and intravascular ultrasound. A flexible microbiopsy forceps was used to remove each intimal flap under angioscopic guidance. Arteriographic lumen diameters were measured and cross-sectional areas calculated. Corresponding measurements by angioscopy and intravascular ultrasound with reduction in luminal area at the flap were obtained by use of computerized planimetry. Uniplanar arteriography identified 60% (6/10) of the intimal flaps, whereas angioscopy and intravascular ultrasound demonstrated 100%. Lumen diameter (in millimeters) measured by arteriography (3.4 +/- 0.6) correlated significantly with measurements by angioscopy (3.5 +/- 0.5, r = 0.77) and intravascular ultrasound (3.5 +/- 0.6, r = 0.96). Similarly, lumen area (square millimeters) by arteriography (9.2 +/- 2.9) correlated with measurements by angioscopy (8.9 +/- 2.2, r = 0.82) and intravascular ultrasound (8.6 +/- 2.7, r = 0.91). Reduction in lumen area by the flap by angioscopy (37 +/- 7%) and intravascular ultrasound (33 +/- 8%) also correlated significantly (r = 0.72). The intimal flaps were removed successfully in all 10 arteries as confirmed by arteriography, angioscopy, and intravascular ultrasound. We conclude that the endovascular management of intimal defects is possible. Additionally, angioscopy and intravascular ultrasound accurately evaluate lumen diameter and area while providing direct assessment of intimal defects.

Animals↗

PubMed1992

The natural history of intimal flaps caused by angioscopy.

UNLABELLED: This study tried to determine the natural history of angioscopy-induced arterial intimal flaps as assessed by video angioscopy, light and transmission electron microscopy. Eight mongrel dogs were anesthetized and bilateral femoral and carotid arteries surgically exposed. A 3.0 mm American Edwards angioscope was inserted into each artery and passed vigorously until an intimal flap was visualized by angioscopy. The location of intimal flaps was externally marked with 6-0 polypropylene adventitial sutures. Animals were then recovered and follow-up angioscopy performed at one, two, three, and four week intervals. Following repeat angioscopy, all animals were sacrificed and vessels perfusion-fixed in situ with 2.5% glutaraldehyde in 0.1 M sodium cacodylate. A total of 37 intimal injuries were created (immediate, n = 10; one week, n = 8; two weeks, n = 4; three weeks, n = 8; four weeks, n = 7). No arterial thrombosis occurred following intimal flap formation. Only one of 37 (2.7%) lesions progressed to a hemodynamically significant stenosis. Histology of immediate lesions demonstrated deep intimal fractures extending into the tunica media. Complete healing of intimal flaps was observed by follow-up angioscopy in zero of eight lesions by one week, zero of four lesions by two weeks, one of eight lesions by three weeks, and four of seven lesions by four weeks (p = 0.02). Light and electron microscopy confirmed the angioscopic intimal fractures and regrowth of denuded endothelium. CONCLUSION: follow-up angioscopy and microscopy one month after angioscopy-induced arterial intimal trauma demonstrated a significant trend towards complete endothelial healing.

Animals↗

PubMed1990

Combined mechanical and chemical thrombolysis in an experimental animal model: evaluation by angiography and angioscopy.

In an experimental animal model of femoral artery thrombosis, contrast angiography was compared to intravascular angioscopy. Additionally, the effect of mechanical, rotational thrombectomy and the additive benefit of the administration of intravascular streptokinase were assessed by means of both procedures. After external forceps crush injury alone, contrast angiograms were generally normal (6 of 14) or showed minimal luminal irregularity (3 of 14), and 5 of 14 had 30% to 50% stenosis. With angioscopy, none appeared normal, and 14 of 14 showed thrombi layered along the wall, as well as intimal flaps, and 6 of 14 had partially occlusive thrombi (p less than 0.001 angiography vs angioscopy). After 2-hour occlusion and injection of thrombin into the injured segment, angiographic total (5 of 14), subtotal (3 of 14), or partial thrombotic occlusions (5 of 14) were created. Angioscopy showed similar results, except that total occlusions were classed as subtotal occlusions. After rotational thrombectomy, most arteries again appeared normal by contrast angiography (6 of 11) but none were angioscopically normal (p less than 0.006). Streptokinase, administered after rotational thrombectomy in seven arteries, normalized one 30% angiographic stenosis; there were no other angiographic changes. Findings with angioscopy were also unchanged. We conclude that in the diagnosis and treatment of intravascular thrombosis, angioscopy is generally more sensitive in the detection of intravascular thrombi, with the exception of total thrombotic occlusions. Angioscopy was uniquely effective in identifying subintimal flaps, which were never identified by angiography. In this model, streptokinase provided little or no additional thrombolytic benefit to mechanical thrombectomy alone.

Angiography↗

PubMed1991

Percutaneous angioscopy during coronary angioplasty using a steerable microangioscope.

The feasibility of using a flexible, steerable angioscope to perform coronary angioscopy before and after percutaneous coronary angioplasty was tested. The microangioscope fits through an 8F coronary angioplasty guiding catheter and contains a multifiber viewing bundle incorporated into the body of a 4.3F balloon catheter with a central lumen for distal flushing and guide-wire passage. Angioscopy was performed without complications 45 times in 24 patients, including 6 patients with stable and 18 with unstable angina. Circumferential visualization of the target lesion was successful in 20 (83%) of the 24 patients and improved with operator experience. Excellent visualization of the target lesion was achieved in 16 (94%) of the last 17 patients. Plaque, thrombus and dissection were among the abnormal findings in the 20 patients (4 with stable, 16 with unstable angina) in whom circumferential viewing of the target lesion was achieved. In four patients with restenosis after angioplasty, the lesion morphology was distinctly different from that of lesions in arteries without prior angioplasty. In patients with stable angina, no thrombus or dissection was seen by angiography or angioscopy before angioplasty. In patients with unstable angina, thrombus was detected more frequently by angioscopy than by angiography before angioplasty (8 versus 2 of 16) and after (15 versus 2 of 16) angioplasty. Intimal dissection was also seen much more frequently by angioscopy than by angiography before angioplasty (7 versus 0 of 16) and after angioplasty (16 versus 7 of 16). It is concluded that high resolution percutaneous coronary angioscopy can be performed safely in conjunction with balloon angioplasty. Further investigation is needed before this diagnostic tool can be applied clinically.

Angina Pectoris↗

PubMed1992

A blinded comparison of angiography, angioscopy, and duplex scanning in the intraoperative evaluation of in situ saphenous vein bypass grafts.

Angiography, angioscopy, and duplex scanning have each been advocated for intraoperative assessment of in situ saphenous vein grafts. We compared these three modalities during operation in a prospective, blinded study during the construction of 20 femoral-infragenicular in situ saphenous vein grafts. Each modality was used and interpreted by a surgeon blinded to the results of the other studies. Abnormalities requiring intervention were defined as (1) patent vein side branches, (2) residual valve cusps, and (3) anastomotic stenoses greater than 30%. Criteria, specific to the modality, corresponding to each category were prospectively defined. Fourteen residual valve cusps, 49 patent vein branches, and 6 anastomotic stenoses were suggested by at least one modality. Nine residual valve cusps, 32 patent vein branches, and no anastomotic stenoses were actually found (and corrected) by direct inspection. Sensitivity of detecting patent side branches for angiography, duplex scanning, and angioscopy was 44%, 12%, and 66%, respectively. Both angiography and angioscopy were significantly more sensitive than duplex scanning for detection of unligated side branches (p less than 0.01). Sensitivity of detecting residual valve cusps was 22% (angiography), 11% (duplex scanning), and 100% (angioscopy). Angioscopy was significantly more sensitive than either duplex scanning or angiography in detection of residual valve cusps (p less than 0.01). Since no anastomotic stenoses were confirmed, the false-positive rates for stenosis detection were 20% for angiography, 10% for duplex scanning, and 0% for angioscopy. Time requirement was 17 to 20 minutes and did not differ among the three modalities. No stenosis or arteriovenous fistula has been detected in any graft by postoperative duplex surveillance (mean, 10-month follow-up).(ABSTRACT TRUNCATED AT 250 WORDS)

Anastomosis, Surgical↗

PubMed1991

Histopathologic validation of angioscopy and intravascular ultrasound.

BACKGROUND: To establish a histopathologic basis for angioscopic and ultrasound image interpretation we studied 70 postmortem human arterial segments in vitro. METHODS AND RESULTS: We used 7- to 9-French fiber-optic angioscopes and 20- to 30-MHz intravascular ultrasound imaging catheters. Three observers assigned an angioscopic and ultrasound image classification to each vessel segment. The image and histological classification categories were then compared. The sensitivity, specificity, and accuracy of both methods separately or in combination for normal vessels were each greater than or equal to 95%. The predictive value was better for angioscopy than for ultrasound due to incorrect ultrasound interpretations of normal anatomy in the presence of thrombus. For stable atheroma the sensitivity, specificity, and accuracy of the individual methods were each greater than 90%. However, both angioscopy and ultrasound had classification errors in that disrupted atheroma was identified and classified as stable atheroma. Consequently, the predictive value was 74% for angioscopy and 78% for ultrasound. For disrupted atheroma the sensitivities for angioscopy and ultrasound were only moderate (73% and 81%, respectively), whereas the specificity, accuracy, and predictive value were each high (greater than 90%). For thrombus detection, the specificity, accuracy, and predictive value were high (greater than 93%) for each method. The sensitivity of angioscopy was 100%. However, sensitivity was lower for ultrasound (57%) due to false-negative interpretation of laminar clots in normal vessels and an inability to distinguish disrupted or stable atheroma from intraluminal thrombus. CONCLUSIONS: Contingency analyses showed that each imaging method alone or combined had significant agreement with the results obtained from histology (p less than 0.001). When assessing all cases in which angioscopy and ultrasound were concordant, there was a 92% agreement with the histological classification.

Coronary Artery Disease↗

PubMed1992

Angioscopy in endovascular surgery: recent technical advances to enhance intervention selection and failure analysis.

Recent technical and procedural modifications have greatly enhanced the usefulness of angioscopy during angioplasty. A pulsed irrigation system, proximal and distal blood flow control by pressure, and attention to sheath/vessel diameter ratio were incorporated into a study in which angioscopy was used for pretreatment assessment in 23 patients with symptomatic peripheral vascular disease presenting for initial (8 patients) evaluation or repeat treatment (15 patients) following a previous vascular procedure. Twenty-five lesions were examined with a 2.3 mm flexible angioscope equipped with an irrigating lumen; there were no complications attributable to angioscopy. The angioscope was useful in the characterization of lesions for selection of the recanalization technique. Lesions more amenable to initial atherectomy were visualized in 12 patients; 7 occlusions were successfully treated with laser/balloon angioplasty, with angioscopy assisting in probe and/or wire passage in 4 cases. Three late reocclusions were identified angioscopically as due solely to thrombosis, indicating the need for thrombolytic therapy. Angioscopy also identified 4 cases of incomplete recanalization despite a satisfactory arteriographic image. Angioscopy was also used to evaluate stenotic lesions unaccompanied by thrombus formation in patients previously treated with laser-assisted angioplasty. Histologic evaluation of the biopsied plaques identified intimal hyperplasia as the etiology, matching identically similar specimens harvested from a lesion treated with balloon dilation only.

Aged↗

PubMed1991

Continued experience with intraoperative angioscopy for monitoring infrainguinal bypass grafting.

Intraoperative angioscopy provides direct, in vivo, three-dimensional visualization of the interior of the blood vessels and grafts. We have shown previously that with the application of the basic principles of irrigation and with a dedicated irrigation pump that routine intraoperative angioscopy can be performed with consistent high quality results during lower extremity revascularization. In our total experience with angioscopy as a monitoring procedure during infrainguinal bypass grafting, 259 intraoperative angioscopies, during 63 femoropopliteal and 196 distal bypass grafts, were performed from May 1, 1987, to October 31, 1989. Mean total irrigation fluid used in the study was 448 ml (range, 0 to 1400 ml) with good visual quality in more than 80% of the studies. The overall failure rate was 1.5%. No complications were directly attributable to the insertion of the angioscope or the use of the pump. Based on the angioscopic findings, 124 clinical or surgical decisions were made in 259 of the angioscopies. The incidence of graft failure in this study was 8.1% (less than 30 days) and 4.8% (greater than 30 days) with a mean follow-up of 272 days. Direct inspection of the interior of the graft and native vessels at the time of surgery has resulted in the recognition of previously unsuspected vein-graft pathology. Angioscopy as the sole monitoring procedure for infrainguinal bypass grafting is safe, effective, and reliable and may not only improve the durability of these grafts but may improve our understanding of the pathogenesis of graft failure and of the progression of the underlying atherosclerotic disease.

Adult↗

PubMed1990

Experimental and clinical percutaneous angioscopy experience with dynamic angioplasty.

The authors have used ultrathin angioscopes with high optical resolution to assess the effects of dynamic angioplasty in vitro and in vivo. Experimentally, angioscopy was used to study the effects of the 5F "Kensey" catheter in "normal" porcine coronary arteries (NPCA) and postmortem human coronary arteries (PMHCA). In NPCA, the catheter keeps a coaxial position. Intimal flaps (IFs) were seen in 21/23 NPCAs. They occurred with all cam rotation speeds and were usually single and small (less than 25% of lumen). Perforations in patent arteries were rare (1/23). However, when the catheter was forced against the wall by passing through a narrowing of 5F diameter (made by a band ligature), perforations were more common at higher cam speeds. The epicardium remained intact in two thirds of perforations. Angioscopy visualized perforations in only 10% of cases (1/10), the common sign being that of large and multiple intimal flaps, which were often obstructive (5/10). In PMHCAs, angioscopy was more sensitive than angiography in detecting atheromatous lesions. The authors were able to give a better assessment of the effect of dynamic angioplasty on treated lesions, including the demonstration of intimal flaps that were not visible on angiography. In vivo, they have performed percutaneous angioscopy before and after dynamic angioplasty using 8 French Kensey catheters. Angioscopy revealed features that were not shown angiographically.

Angioplasty, Balloon↗

PubMed1992

The effectiveness of coronary angioscopy in detecting intraluminal pathologic changes.

We have evaluated the feasibility of percutaneous transluminal coronary angioscopy for detecting intraluminal pathological changes as a diagnostic tool, and investigated the pathogenesis of two acute coronary disorders, acute myocardial infarction and unstable angina. Twelve patients with an acute coronary disorder and 20 patients who underwent percutaneous transluminal coronary angioplasty were selected for this comparison between the diagnostic accuracy of angioscopy and arteriography. One hundred and thirty patients were investigated by angioscopy as follows in order to investigate the pathogenesis of their acute coronary disorders: 22 within 8 h of onset acute myocardial infarction; 28 from one day to 2 months since onset recent myocardial infarction; 37 with an old myocardial infarction; 26 with unstable angina; and 23 with stable angina. Our results have indicated thrombi were detected more frequently by angioscopy than by arteriography (p less than 0.01). Also, 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 coronary angioscopy is a much more sensitive method for detecting intraluminal changes, and 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 precede its rupture.

Coronary Angiography↗

PubMed1992

[Angioscopy in peripheral vascular surgery].

At Saint-Luc's Hospital of Montreal, between January 1, 1990 and February 1, 1991, 47 angioscopic procedures were done in 43 patients submitted to peripheral vascular reconstructions. The purpose of the study was to evaluate the role of angioscopy during those procedures. The operations were as follows: twenty femoropopliteal bypasses done with reversed saphenous vein, 15 done with in situ saphenous veins and 10 done with synthetic grafts. Two patients had popliteal embolectomies. Seventeen percent of the cases showed technical problems with the use of controlled angioscopy and were subsequently corrected. Three residual valves and one unsuspected venous stenosis were found in 15 in situ grafts, for a total of 27% correctible defects. In the reversed saphenous group, one case of venous sclerosis and one case of anastomotic stenosis were found for a total of 10%. For the synthetic grafts group we found an intimal flap distal to the anastomosis in one case (10%). Finally, we found a significant residual clot in one case (50%) after embolectomy. The technique of angioscopy is simple, the equipment reliable, and the learning period is short. Angioscopy is a very useful approach and should be readily available in the armamentarium of every vascular surgeon.

Adult↗

PubMed1990

Angioscopy for intraoperative management of thromboembolectomy.

Our experience with angioscopy suggests that direct visualization of the arterial lumen during thromboembolectomy procedures would provide a more reliable method of assessing luminal morphologic characteristics than angiography alone. We inspected 32 grafts (seven aortobifemoral, 18 infrainguinal bypass, and seven dialysis access fistula grafts) in 32 patients. Thirty-one patients had thrombotic events and one patient had an acute embolus. Angioscopy following standard catheter thrombectomy revealed significant amounts of retained thrombus or neointima in all thrombectomies. Angioscopic information from 18 patients with an infrainguinal bypass graft led to graft revision in six cases and placement of a new graft in 10 cases. One graft limb was replaced in seven aortobifemoral grafts, and multiple repeated thrombectomies were employed to extract debris in the remaining six cases. Repeated graft thrombectomy was also beneficial in dialysis access fistulas. Angioscopy allowed us to omit the completion angiogram and led to an improved technical result. We conclude that angioscopy is useful during thromboembolectomy procedures.

Aged↗

PubMed1992

Safety of saline irrigation for angioscopy: results of a prospective randomized trial.

This study evaluates the hemodynamic effects and safety of saline irrigation necessary to obtain high-quality completion angioscopic studies, as compared with standard completion arteriography during infrainguinal bypass grafting. One-hundred ten patients undergoing primary infrainguinal bypass grafting, were prospectively randomized to either arteriography (N = 50) or angioscopy (N = 60) for a completion study to monitor the bypass procedure. All patients were hemodynamically monitored with pulmonary artery catheters and arterial lines. The arteriography group received an average of 27 ml (range 8-60 ml) of contrast per completion study, with a total administered intraoperative fluid volume of 2095 ml (range 650-4000 ml). The angioscopy group received an average bolus of 321 ml (range 90-650 ml) of irrigation fluid per completion angioscopy study, with a total administered intraoperative fluid volume of 2140 ml (range 850-5000 ml). Transient increases in pulmonary artery systolic and diastolic pressures and central venous pressures were measured during angioscopy. Although these changes reached statistical significance, the changes were of minimal clinical relevance, 1.9 (= 4.5), 1.6 (= 3.0) and 1.4 (= 2.3) mmHg respectively, and returned to baseline levels within 30 minutes. Intraoperative intervention with vasodilators and diuretics, the perioperative cardiac morbidity, and less than 30 day mortality, was not different between the two groups. Pressures generated within 24 bypass grafts were within physiologic arterial range for most of the study. With careful angioscopic technique applied and high quality care extended to the patient, irrigation with saline solution is simple, effective and safe.

Angiography↗

PubMed1990

Angiography, angioscopy, and ultrasound imaging before and after percutaneous balloon angioplasty.

We report two patients undergoing peripheral percutaneous transluminal angioplasty in whom angiography, angioscopy, and ultrasound imaging were performed before and after balloon angioplasty. The first case with smooth atheroma diagnosed by angiography was found to have unrecognized partially occlusive thrombus by angioscopy. After angioplasty, an intimal tear was identified by angioscopy and ultrasound but it was not seen by angiography. The intravascular ultrasound image showed the tear to extend to the adventitia. In the second case, an apparently smooth intimal surface as imaged by angiography was found by angioscopy and ultrasound to have extensive damage, including subintimal hemorrhage, intimal flaps, and arterial dissection at the angioplasty site. These data suggest that the type of information derived from the three imaging techniques is quite different, and that each may have a specific role in intravascular diagnosis.

Aged↗

PubMed1991

Percutaneous coronary angioscopy in patients with restenosis after coronary angioplasty.

Percutaneous transluminal coronary angioscopy with a flexible steerable microangioscope was performed in five patients undergoing repeat angioplasty. Recurrent lesions were assessed by angioscopy before and after the angioplasty procedure. The most common surface morphology observed in these restenosis lesions was that of white unpigmented lesions consistent with the proliferation of fibrous tissue. Also noted during angioscopy was the presence or absence of thrombus or dissection in association with the lesions either before or after angioplasty. Filmy wisps of tissue, presumably intimal flaps, were commonly visualized after angioplasty. There were no complications related to angioscopy or angioplasty in these patients. The surface morphology of restenosis lesions appears to be different from that of primary atherosclerotic lesions. The lesions in these five patients with restenosis were generally white and fibrotic in appearance, as opposed to the pigmented yellow to yellow-brown lesions commonly seen in undilated atherosclerotic lesions. It was also noted that the presence of intracoronary thrombus was strongly associated with the clinical syndrome of unstable angina. These findings support the hypothesis that restenosis lesions are the result of a reparative process consisting of smooth muscle cell proliferation and fibrosis.

Adult↗

PubMed1976

Fluorescein angioscopy: techniques of partial fluorescence, permanent drawing record and photocoagulation.

Fluorescein angioscopy with the indirect ophthalmoscope might be the preferred technique for evaluating and treating certain lesions, particularly those in the retinal periphery. Three techniques which are helpful in extending the advantages of angioscopy are described. (1) Partial fluorescence is achieved with careful adjustment of the cobalt blue filter which relates the fluorescence to retinal landmarks, ie, color angioscopy. (2) A permanent record of angioscopy in different phases can be made with tracing paper over the retinal drawing. (3) Correct localization of lesions to be coagulated is achieved with blue filters over the coagulator beam following fluorescein injection. The filter is removed during coagulation.

Color↗