4D phase contrast flow imaging for in-stent flow visualization and assessment of stent patency in peripheral vascular stents – A phantom study

Bunck, Alexander C.; Jüttner, Alena; Kröger, Jan Robert; Burg, Matthias C.; Kugel, Harald; Niederstadt, Thomas; Tiemann, Klaus; Schnackenburg, Bernhard; Crelier, Gérard; Heindel, Walter; Maintz, David

doi:10.1016/j.ejrad.2012.05.032

Cited by 20 publications

(22 citation statements)

References 21 publications

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“…A recent phantom study showed that in-stent flow quantification varies depending on the type of stent used; however, a covered TIPS stent was not assessed (32). Future phantom studies are needed to assess this issue.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Monitoring of Hepatic Blood Flow before and after TIPS by Using 4D-Flow MR Imaging

Bannas¹,

Roldán‐Alzate²,

Johnson³

et al. 2016

Radiology

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Purpose To demonstrate the feasibility of four-dimensional (4D)– flow magnetic resonance (MR) imaging for noninvasive longitudinal hemodynamic monitoring of hepatic blood flow before and after transjugular intrahepatic portosystemic shunt (TIPS) placement. Materials and Methods The institutional review board approved this prospective Health Insurance Portability and Accountability Act compliant study with written informed consent. Four-dimensional–flow MR imaging was performed in seven patients with portal hypertension and refractory ascites before and 2 and 12 weeks after TIPS placement by using a time-resolved three-dimensional radial phase-contrast acquisition. Flow and peak velocity measurements were obtained in the superior mesenteric vein (SMV), splenic vein (SV), portal vein (PV), and the TIPS. Flow volumes and peak velocities in each vessel, as well as the ratio of in-stent to PV flow, were compared before and after TIPS placement by using analysis of variance. Results Flow volumes significantly increased in the SMV (0.24 L/ min; 95% confidence interval [CI]: 0.07, 0.41), SV (0.31 L/min; 95% CI: 0.07, 0.54), and PV (0.88 L/min; 95% CI: 0.06, 1.70) after TIPS placement (all P < .05), with no significant difference between the first and second post-TIPS placement acquisitions (all P > .11). Ascites resolved in six of seven patients. In those with resolved ascites, the TIPS-to-PV flow ratio was 0.8 ± 6 0.2 and 0.9 ± 0.2 at the two post-TIPS time points, respectively, while the observed ratios were 4.6 and 4.3 in the patient with refractory ascites at the two post-TIPS time points, respectively. In this patient, 4D-flow MR imaging demonstrated arterio-portal-venous shunting, with draining into the TIPS. Conclusion Four-dimensional–flow MR imaging is feasible for noninvasive longitudinal hemodynamic monitoring of hepatic blood flow before and after TIPS placement.

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Section: Discussionmentioning

confidence: 99%

Longitudinal Monitoring of Hepatic Blood Flow before and after TIPS by Using 4D-Flow MR Imaging

Bannas¹,

Roldán‐Alzate²,

Johnson³

et al. 2016

Radiology

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“…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. They also showed that quantitative and qualitative assessment of the in-stent flow was reliable and could be used even in pathological conditions.…”

Section: Discussionmentioning

confidence: 99%

“…It is well known that endovascular implants are related to metal artifacts and signal void issues depending on the metallic composition of the alloy 23. 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.…”

Section: Introductionmentioning

confidence: 99%

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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“…Aside from resolution constraints, magnetic resonance imaging–based techniques for in vivo flow quantification in stents create considerable material-dependent artifacts that may inhibit quantitative analysis near the stent configuration. 23 Contrast-enhanced, high-frame-rate, ultrasound-based techniques (echoPIV) could prove to be a convenient modality to quantify the in- and outflow of stent configurations. Until now, echoPIV techniques have been used only in superficial vessels and cardiac applications in a research setting.…”

Section: Discussionmentioning

confidence: 99%

Influence of Iliac Stenotic Lesions on Blood Flow Patterns Near a Covered Endovascular Reconstruction of the Aortic Bifurcation (CERAB) Stent Configuration

et al. 2017

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Purpose: To investigate the effect of distal stenotic lesions on flow patterns near a covered endovascular reconstruction of the aortic bifurcation (CERAB) configuration used in the treatment of aortoiliac occlusive disease. Method: Laser particle image velocimetry measurements were performed using in vitro models of the aortic bifurcation with and without a CERAB configuration in place. A hemodynamically nonsignificant stenosis (ΔP: 9 mm Hg), a hemodynamically significant (ΔP: 26 mm Hg) stenosis, and a total occlusion were simulated in the left iliac arteries. Velocity fields and time-averaged wall shear stress (TAWSS) were calculated. Results: Hemodynamically significant distal lesions did not influence the inflow patterns or TAWSS (0.5–0.6 Pa) in either model. However, hemodynamically significant distal stenotic lesions caused a 2-fold decrease in peak outflow velocities (control: 106 vs 56 cm/s, CERAB: 96 vs 54 cm/s) and a 3-fold decrease in TAWSS (control: 1.34 vs 0.44 Pa, CERAB: 0.75 vs 0.21 Pa). There was a 2-fold decrease in wall shear stress in the CERAB outflow compared with the control, independent of lesion severity. Conclusion: In the CERAB technique, adequate distal runoff is identified as an important parameter to ensure patency. This in vitro study showed that distal stenotic lesions influence aortic bifurcation outflow patterns and TAWSS more extensively in the CERAB configuration. Distal stenotic lesions could therefore increase the risk of disease progression and loss of stent patency. In vivo studies are necessary to confirm these observations.

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4D phase contrast flow imaging for in-stent flow visualization and assessment of stent patency in peripheral vascular stents – A phantom study

Cited by 20 publications

References 21 publications

Longitudinal Monitoring of Hepatic Blood Flow before and after TIPS by Using 4D-Flow MR Imaging

Longitudinal Monitoring of Hepatic Blood Flow before and after TIPS by Using 4D-Flow MR Imaging

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

Influence of Iliac Stenotic Lesions on Blood Flow Patterns Near a Covered Endovascular Reconstruction of the Aortic Bifurcation (CERAB) Stent Configuration

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