MR‐guided intravascular interventions: Techniques and applications

Abstract

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.

MRI-based communication for untethered intelligent medical microrobots

“…A physician can use a linear back and forth movement as well as rotating the catheter around its axis in order to steer it. This method of actuation might cause many complications such as exposing the patient to more radiation, longer procedure time, hematoma, and the puncture of vessels [121]. Some methods use x-ray fluoroscopy to guide the catheter through the arterial system.…”

“…The idea of using an upgraded Magnetic Resonance Imaging (MRI) system to facilitate the steering of a catheter has been proposed and investigated in many studies [122][123][124][125] Using a MRI system not only excludes the ionizing radiation exposure but also enhances the soft tissue contrast in the images [123]. Moreover, fluoroscopy can only describe the lumen of the vessels while MRI can visualize the morphology of the soft tissue surrounding the blood vessels [121,124] Different research propose the idea of placing wound coils at the distal end of a catheter to guide the catheter during intravascular procedures using MRI. A catheter with three orthogonal coils on its tip is proposed in [122].…”

Multimodality Noninvasive Imaging for Assessment of Congenital Heart Disease

“…Impediments to the implementation of interventional CMR include its relatively low temporal resolution, limited availability of MR-compatible catheters and devices and technical difficulties in visualizing and tracking catheter tips and devices during manipulation. 98,99 …”

Comparative ergonomic workflow and user experience analysis of MRI versus fluoroscopy-guided vascular interventions: an iliac angioplasty exemplar case study

“…However, MRI environments present operational challenges that need to be addressed in order to make MRI-guided procedures comparable to fluoroscopy in terms of safety, efficiency and efficacy, and acceptable for clinical practice. Much of the currently published research focuses on overcoming technical limitations and safety issues [2,3]. In addition, concerns on the potential longer procedural times have been reported in previous studies [4].…”

“…The technology, devices and MRI protocols involved in this work and a detailed description of the environmental setup were first presented in Rube et al [14]. In contrast, this paper focuses in the procedural protocol evaluation, which is done from multiple viewpoints with regard to previously cited authors [2,3,8]. The framework included a time-based and cognitive task analysis via CRPA to assess clinical performance in several different scenarios using the MRI-guided protocol.…”