Introduction It is not possible to clearly delineate pathological changes in the inner vessel wall with digital subtraction angiography. Angioscopy enables the detection of endothelial pathologies, as demonstrated in the cardiovascular system.[1] In the case of the internal carotid artery, angioscopic imaging has the potential to visualize pathologies as well as the endothelialisation of stents or flow diverters.[2-3]

Aim of Study Verification of the applicability of angiography in the internal carotid artery using vascular endoscopy.

Methods Five internal carotid artery specimens with varying degrees were selected from angiography images (January 2022 to December 2023) at the Department of Neuroradiology, University Hospital, Magdeburg, Germany. The vessel models consist of transparent tubes, optionally with a stent or a flow diverter. Testing includes tracking the movement of a fibre-optic endoscope and endoscopic imaging during retraction. Colour resolution is assessed by marking the tubes to simulate discolouration of the vessel wall.

Results The endoscope was successfully inserted into all vascular models up to the distal end. As vascular tortuosity increased, more force was required to follow the vascular course and ensure precise endoscope placement. Endoscopic recordings showed promising results in all cases. The structure of the stents and flow diverters as well as the different colour markings were distinguishable.

Conclusion The use of angioscopy in the internal carotid artery is a promising clinical imaging technique for visualising intimal changes and devices. Vascular endoscopy can be successfully applied to varying degrees of tortuosity in all vascular models, with increasing shear stress.

Disclosure of Interest no.