This study was undertaken to observe coronary
thrombus formation serially from an antegrade perspective by means of a new thin flexible
angioscope that has an inflatable balloon at the distal tip and an angulation mechanism. To test its capabilities, thrombi were induced in the left anterior descending coronary artery of 11 dogs by
copper coils, and the thrombi were then observed through this
angioscope, which had been introduced into the coronary artery by a guide
catheter. Five minutes after insertion of the
copper coil,
fibrin-like material and white components of the thrombi were seen massing around the
copper coil. Then, thin, mixed thrombotic white and red components formed around the
copper coil. At fifteen minutes after the
copper coil insertion, the thrombi grew in size. Ten minutes later, the thrombi finally obstructed the coronary lumen in most dogs. The red and white appearance of these thrombi was confirmed macroscopically, and the microscopic findings of these occluding thrombi revealed a fibrinous network with platelet aggregates and blood cell coagulation. Though ordinary angiography cannot reveal the precise features of the various coronary thrombi, this new
angioscope was able to discern them from the antegrade perspective. The capabilities of this
angioscope, which enabled these findings, should prove helpful in evaluating the stages of human
coronary thrombosis. Of additional benefit, this
angioscope can be used clinically for cardiac catheterization.