A next-generation, flow-diverting implant used to treat brain aneurysms: in vitro evaluation of magnetic field interactions, heating and artifacts at 3-T

Karacozoff, Alexandra M.; Shellock, Frank G.; Wakhloo, Ajay K.

doi:10.1016/j.mri.2012.06.015

Cited by 10 publications

(25 citation statements)

References 12 publications

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“…However, susceptibility artifacts in the imaging of the stented vasculature remain an issue in evaluating the postoperative status, particularly with high material density prostheses 26 27. In particular, it was shown by Karacozoff et al 25 that the imaging of the surpass FDS was safe but was altered by artifacts. However, Bunks et al showed that 4D flow imaging could be used to measure intra-stent flow in an in vitro experiment using different types of peripheral stents 24.…”

Section: Discussionmentioning

confidence: 99%

“…Because the patients’ head positions were slightly different between the pre- and post-procedure MRI, the ROIs were manually delineated on equivalent slices visualized in velocity magnitude and were restricted to the internal contour of the aneurysm, with special attention paid to avoiding contamination by the parent vessel velocity components and far enough from stent artifacts, as recommended by Karacozoff et al 25 The positioning of the ROI on the aneurysm is shown in figure 1. Additionally, we defined ROIs in the C4 segment of the ICA for both flow datasets.…”

Section: Methodsmentioning

confidence: 99%

“…However, Bunks et al experimentally showed that 4D flow imaging could be used to measure intra-stent flow in different types of peripheral stents 24. Karacozoff et al 25 reported that surpass NeuroEndograft FDS-related artifacts may be problematic if the region of interest is in the same area or close to the implant. In the same study they also reported that MRI of the same device presents no concerns with regard to heating and magnetic field interactions.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Assessment of intra-aneurysmal flow modification after flow diverter stent placement with four-dimensional flow MRI: a feasibility study

Pereira

Brina

Delattre

et al. 2014

J NeuroIntervent Surg

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Assessment of intra-aneurysmal flow modification after flow diverter stent placement with four-dimensional flow MRI: a feasibility study

Pereira

Brina

Delattre

et al. 2014

J NeuroIntervent Surg

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“…The following qualitative scale of torque was applied to the results: 0, no torque; +1, mild or low torque, the device slightly changed orientation but did not align to the magnetic field; +2, moderate torque, the device aligned gradually to the magnetic field; +3, strong torque, the device showed rapid and forceful alignment to the magnetic field; +4, very strong torque, the device showed both very rapid and forceful alignment to the magnetic field .…”

Section: Methodsmentioning

confidence: 99%

In Vitro Magnetic Resonance Imaging Evaluation of Fragmented, Open-Coil, Percutaneous Peripheral Nerve Stimulation Leads

Shellock

Zare

Ilfeld

et al. 2018

Neuromodulation: Technology at the Neural Interface

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Objective: Percutaneous peripheral nerve stimulation (PNS) is an FDA-cleared pain treatment. Occasionally, fragments of the lead (MicroLead, SPR Therapeutics, LLC, Cleveland, OH, USA) may be retained following lead removal. Since the lead is metallic, there are associated magnetic resonance imaging (MRI) risks. Therefore, the objective of this investigation was to evaluate MRI-related issues (i.e., magnetic field interactions, heating, and artifacts) for various lead fragments.Methods: Testing was conducted using standardized techniques on lead fragments of different lengths (i.e., 50, 75, and 100% of maximum possible fragment length of 12.7 cm) to determine MRI-related problems. Magnetic field interactions (i.e., translational attraction and torque) and artifacts were tested for the longest lead fragment at 3 Tesla. MRI-related heating was evaluated at 1.5 Tesla/64 MHz and 3 Tesla/128 MHz with each lead fragment placed in a gelled-saline filled phantom. Temperatures were recorded on the lead fragments while using relatively high RF power levels. Artifacts were evaluated using T1-weighted, spin echo, and gradient echo (GRE) pulse sequences. Results:The longest lead fragment produced only minor magnetic field interactions. For the lead fragments evaluated, physiologically inconsequential MRI-related heating occurred at 1.5 Tesla/64 MHz while under certain 3 Tesla/128 MHz conditions, excessive temperature elevations may occur. Artifacts extended approximately 7 mm from the lead fragment on the GRE pulse sequence, suggesting that anatomy located at a position greater than this distance may be visualized on MRI.Conclusions: MRI may be performed safely in patients with retained lead fragments at 1.5 Tesla using the specific conditions of this study (i.e., MR Conditional). Due to possible excessive temperature rises at 3 Tesla, performing MRI at that field strength is currently inadvisable.

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“…46 A catheter angiography and less-invasive computed tomography angiography are best suited for assessment of the treated artery and aneurysm.…”

Section: June 2013mentioning

confidence: 99%

New Generation of Flow Diverter (Surpass) for Unruptured Intracranial Aneurysms

Vries

Boogaarts

Norden

et al. 2013

Stroke

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Background and Purpose— In patients harboring intracranial aneurysms, the major goal in treatment is to prevent bleeding. A new generation of an endoluminal device (Surpass Flow Diverter [Surpass]) was developed to reconstruct parent artery and occlude the aneurysm. We present our clinical and angiographic single-center experience. Methods— Patients with a wide range of complex unruptured aneurysms were treated with the Surpass placed in the parent artery and bridging the aneurysm. Clinical and angiographic follow-up were performed at 6 months. Data were prospectively collected. Results— Thirty seven patients (mean age, 56 years; range, 32–79), harboring 49 unruptured aneurysms were treated at our center. All except 1 patient were treated with a single device. Successful delivery of the device was achieved in all patients. All 35 nonbifurcation aneurysm necks were covered completely, whereas 14 bifurcation aneurysms were only partially covered. There was no major periprocedural morbidity or mortality. During follow-up, 4 patients (10.4%) experienced transient neurological deficit. One patient (3%) developed a minor stroke at 4-month follow-up with persistent neurological deficit. Twelve patients had neurological symptoms related to their aneurysm and 7 showed improvement of these symptoms during follow-up. At 6-month follow-up, 29 of 31 aneurysms studied that had complete neck coverage showed a complete occlusion (94%) including 1 case with a 95% to 100% occlusion, whereas 5 of the 10 bifurcation aneurysms were occluded. Conclusions— Our study shows high safety and efficacy profile of a new generation endoluminal device in treatment of complex intracranial aneurysms. Long-term studies of treated bifurcation aneurysms are needed.

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A next-generation, flow-diverting implant used to treat brain aneurysms: in vitro evaluation of magnetic field interactions, heating and artifacts at 3-T

Cited by 10 publications

References 12 publications

Assessment of intra-aneurysmal flow modification after flow diverter stent placement with four-dimensional flow MRI: a feasibility study

Assessment of intra-aneurysmal flow modification after flow diverter stent placement with four-dimensional flow MRI: a feasibility study

In Vitro Magnetic Resonance Imaging Evaluation of Fragmented, Open-Coil, Percutaneous Peripheral Nerve Stimulation Leads

New Generation of Flow Diverter (Surpass) for Unruptured Intracranial Aneurysms

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