MR-guided Angioplasty of Renal Artery Stenosis in a Pig Model: A Feasibility Study

Omary, Reed A.; Frayne, Richard; Ünal, Orhan; Warner, Thomas T.; Korosec, Frank R.; Mistretta, Charles A.; Strother, Charles M.; Grist, Thomas M.

doi:10.1016/s1051-0443(07)61433-x

Cited by 75 publications

(38 citation statements)

References 26 publications

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“…To create a negative contrast small paramagnetic rings or magnetite mixtures have been applied (28,29) (Fig. 2), whereas a positive contrast has been achieved with paramagnetic contrast agents in the catheter lumen (30) or on the surface of the catheter (31,32).…”

Section: Mr-visible Markersmentioning

confidence: 99%

MR‐guided intravascular interventions: Techniques and applications

Bock

Wacker

2008

Magnetic Resonance Imaging

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Magnetic resonance imaging (MRI) offers several advantages over other imaging modalities that make it an attractive imaging tool for diagnostic and therapeutic procedures. This tremendous potential of MRI has provided the rationale for increased attention toward MR-guided endovascular interventions. MR guidance has been used recently to navigate endovascular catheters and deliver stents, vena cava filters, embolization materials, and septum closure devices. However, its potential goes beyond just copying existing procedures toward the development of new minimally invasive techniques that cannot be performed with conventional guiding techniques. Because of technical limitations and safety issues associated with some of the currently available devices, a limited number of clinical studies have been performed so far. The overall success for this developing field requires considerable interdisciplinary research within both the interventional and the MR community. Only through a combined effort can this complex technology find its way into clinical practice. This review discusses the hardware and software improvements that have helped to advance endovascular interventions under MR imaging guidance from a pure research tool to become a clinical reality. In addition, technical and safety issues specific to endovascular MR image guidance will be described and practical applications will be shown that take advantage of the benefits of MR for endovascular interventions.

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Section: Mr-visible Markersmentioning

confidence: 99%

MR‐guided intravascular interventions: Techniques and applications

Bock

Wacker

2008

Magnetic Resonance Imaging

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“…[22][23][24] In these studies, passive catheter-tracking techniques were used to guide catheters and monitor balloon inflation. This was based on the use of gadolinium contrast media, which would be safe, but it requires imaging with T1-weighted gradient echo sequences that provide a lower signal-to-noise ratio than T1/T2-weighted real-time steady state free precession (SSFP).…”

Section: Editorial P 1051 Clinical Perspective P 1100mentioning

confidence: 99%

Magnetic Resonance Imaging–Guided Balloon Angioplasty of Coarctation of the Aorta

et al. 2006

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Background-MRI guidance of percutaneous transluminal balloon angioplasty (PTA) of aortic coarctation (CoA) would be desirable for continuous visualization of anatomy and to eliminate x-ray exposure. The aim of this study was (1) to determine the suitability of MRI-controlled PTA using the iron oxide-based contrast medium Resovist (ferucarbotran) for catheter visualization and (2) to subsequently apply this technique in a pilot study with patients with CoA. Methods and Results-The MRI contrast-to-noise ratio and artifact behavior of Resovist-treated balloon catheters was optimized in in vitro and animal experiments (pigs). In 5 patients, anatomy of the CoA was evaluated before and after intervention with high-resolution respiratory-navigated 3D MRI and multiphase cine MRI. Position monitoring of Resovist-treated catheters was realized with interactive real-time MRI. Aortic pressures were continuously recorded.Conventional catheterization was performed before and after MRI to confirm interventional success. During MRI, catheters filled with 25 mol of iron particles per milliliter of Resovist produced good signal contrast between catheters and their background anatomy but no image distortion due to susceptibility artifacts. All MRI procedures were performed successfully in the patient study. There was excellent agreement between the diameters of CoA and pressure gradients as measured during MRI and conventional catheterization. In 4 patients, PTA resulted in substantial widening of the CoA and a decrease in pressure gradients. In 1 patient, PTA was ineffective. Conclusions-The MRI method described represents a potential alternative to conventional x-ray fluoroscopy for catheter-based treatment of patients with CoA. (Circulation. 2006;113:1093-1100.)

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“…MR HAS BEEN PROPOSED as an imaging modality to guide endovascular therapies (1)(2)(3)(4)(5)(6). Recent developments, demonstrated in animals, include positioning of catheters into the carotid arteries (2), the renal artery (4,5), and the iliac artery (3), and coil placement in experimental aneurysm models (6).…”

mentioning

confidence: 99%

“…Recent developments, demonstrated in animals, include positioning of catheters into the carotid arteries (2), the renal artery (4,5), and the iliac artery (3), and coil placement in experimental aneurysm models (6). In an editorial, Strother (1) suggested that the real advantage of MRguided endovascular therapies may not be to improve catheter guidance, but rather to provide added value by improving the monitoring of therapy.…”

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confidence: 99%

MRI of ischemic stroke in canines: Applications for monitoring intraarterial thrombolysis

Harris

Kosior

Ryder

et al. 2007

Magnetic Resonance Imaging

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Purpose: To describe a canine embolic stroke model that is appropriate for endovascular procedure evaluations and develop local cerebral blood flow (CBF) maps to monitor the progression of stroke and thrombolysis. In the future, MR may displace X-ray imaging in some endovascular procedures, such as intraarterial (IA) thrombolysis for stroke therapy, due to increased monitoring capabilities. For MR to attain its full potential in endovascular therapy, the development of appropriate disease models and monitoring techniques is essential. Materials and Methods:The canine stroke model uses an injection of autologous clot to produce ischemic and infarcted tissue and produces a range of stroke severities within the anterior cerebral circulation. Local CBF maps were formed by using the catheter that would be in place to deliver the thrombolytic agent for treatment to deliver the gadolinium-based contrast agent for perfusion imaging. Results:After the injection of clot, changes on imaging were consistent with the progression of ischemic stroke. Local CBF maps showed perfusion changes with stroke progression and treatment. Conclusion:We successfully demonstrate the progression of ischemic stroke in the canine to mimic the progression of human stroke. CBF maps to show local perfusion characteristics show great potential in the evaluation of stroke therapy.

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MR-guided Angioplasty of Renal Artery Stenosis in a Pig Model: A Feasibility Study

Cited by 75 publications

References 26 publications

MR‐guided intravascular interventions: Techniques and applications

MR‐guided intravascular interventions: Techniques and applications

Magnetic Resonance Imaging–Guided Balloon Angioplasty of Coarctation of the Aorta

MRI of ischemic stroke in canines: Applications for monitoring intraarterial thrombolysis

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