Magnetic Resonance-Guided Percutaneous Angioplasty of Femoral and Popliteal Artery Stenoses Using Real-Time Imaging and Intra-arterial Contrast-Enhanced Magnetic Resonance Angiography

Paetzel, Christian; Zorger, N.; Bachthaler, Maike; Hamer, Okka W.; Stehr, A.; Feuerbach, Stefan; Lenhart, Markus; Völk, Markus; Herold, Thomas; Kasprzak, Piotr; Nitz, Wolfgang R.

doi:10.1097/01.rli.0000159876.09033.2e

Cited by 43 publications

(31 citation statements)

References 16 publications

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“…MR imaging provides sequential anatomical and physiological data prior to, during and after interventions. It offers a 3D-view of the endovascular devices, vascular and cardiac walls [9][10][11][12]. The progress in iCMR is additionally highlighted by the introduction of high-speed parallel MR imaging [13,14] and high-field scanners [15].…”

Section: Mr Imagingmentioning

confidence: 99%

An overview on the advances in cardiovascular interventional MR imaging

Saborowski

Saeed

2007

Magn Reson Mater Phy

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Interventional cardiovascular magnetic resonance imaging (iCMR) represents a new discipline whose systematic development will foster minimally invasive interventional procedures without radiation exposure. New generations of open, wide and short bore MR scanners and real time sequences made cardiovascular intervention possible. MR compatible endovascular catheters and guide-wires are needed for delivery of devices such as stents or atrial septal defect (ASD) closures. Catheter tracking is based on active and passive approaches. Currently performed MR-guided procedures are used to monitor, navigate and track endovascular catheters and to deliver local therapeutic agents to targets, such as infarcted myocardium and vascular walls. Heating of endovascular MR catheters, guide-wires and devices during imaging still presents high safety risks. MR contrast media improve the capabilities of MR imaging by enhancing blood signal, pathologic targets (such as myocardial infarctions and atherosclerotic plaques), endovascular catheters and by tracking injected therapeutic agents. Labeling injected soluble therapeutic agents, genes or cells with MR contrast media enables interventionalists to ensure the administration of the drugs in the target and to trace their distribution in the targets. The future clinical use of this iCMR technique requires (1) high spatial and temporal resolution imaging, (2) special catheters and devices and (3) effective therapeutic agents, genes or cells. These conditions are available at a low scale at the present time and need to be developed in the near future. Such progress will lead to improved patient care and minimize invasiveness.

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Section: Mr Imagingmentioning

confidence: 99%

An overview on the advances in cardiovascular interventional MR imaging

Saborowski

Saeed

2007

Magn Reson Mater Phy

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“…Due to the lack of clinically approved instruments, only a few reports can be found in the literature about applications in patients (4,64,79,80). In these clinical pilot studies the conventional procedure was largely copied from fluoroscopy or DSA, and the general feasibility of MR-guided endovascular interventions could be shown.…”

Section: Endovascular Applicationsmentioning

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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“…10) [27,46,[72][73][74][75][76][77][78][79][80][81][82][83][84]. First interventional procedures have been demonstrated in humans with conventional devices [85]. As pioneers, in 2000 Manke et al [69] successfully performed MR-guided stent angioplasty of iliac artery stenoses using the passive tracking approach.…”

Section: In Vivo Applicationsmentioning

confidence: 99%

“…Description of active near real-time catheter tracking using radiofrequency coils Bakker et al [20] 1997 First passive catheter tracking in human Wildermuth et al [16] 1997 First MR-guided PTA (swine) Bücker et al [72] 1998 Endovascular stent placement (swine) Kee et al [81] 1999 TIPS placement (swine) Lardo et al [73] 2000 Radiofrequency ablation of the heart (dog) Omary et al [46] 2000 Angioplasty of renal artery stenoses (swine) Manke et al [69] 2000 Stent placement in pelvic artery stenoses (human) Bücker et al [83] 2001 Filter placement in the inferior vena cava (swine) Bücker et al [78] 2002 Placement septal closure device (swine) Spüntrup et al [79] 2002 Coronary artery stent placement (swine) Serfaty et al [80] 2003 Coronary catheterization and PTCA (dog) Razavi et al [12] 2003 Cardiac catheterization in children and adults with congenital heart disease (human) Bücker et al [76] 2003 Coil-Embolisation of renal arteries (swine) Bock et al [54] a 2004 Real-Time parameter control and automated slice repositioning with active tracking coils Wacker et al [56] a 2004 The catheter driven MRI scanner Kühne et al [84] 2004 Aortic valve positioning (swine) Mahnken et al [82] 2004 Aortic stent graft placement (swine) Paetzel et al [85] 2004 PTA of femoral and popliteal stenoses (human) Quick et al [61] a 2005 Wireless active catheter visualization Mekle et al [40] a 2006 Description of the MR-compatible PEEK guidewire a As a backbone for temporal orientation, some relevant technical innovations are included.…”

Section: Safety Aspectsmentioning

confidence: 99%

MR-guided endovascular interventions: a comprehensive review on techniques and applications

et al. 2007

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The magnetic resonance (MR) guidance of endovascular interventions is probably one of the greatest challenges of clinical MR research. MR angiography is not only an imaging tool for the vasculature but can also simultaneously depict high tissue contrast, including the differentiation of the vascular wall and perivascular tissues, as well as vascular function. Several hurdles had to be overcome to allow MR guidance for endovascular interventions. MR hardware and sequence design had to be developed to achieve acceptable patient access and to allow real-time or near real-time imaging. The development of interventional devices, both applicable and safe for MR imaging (MRI), was also mandatory. The subject of this review is to summarize the latest developments in real-time MRI hardware, MRI, visualization tools, interventional devices, endovascular tracking techniques, actual applications and safety issues.

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Magnetic Resonance-Guided Percutaneous Angioplasty of Femoral and Popliteal Artery Stenoses Using Real-Time Imaging and Intra-arterial Contrast-Enhanced Magnetic Resonance Angiography

Abstract: MR-guided balloon dilation of femoral and popliteal artery stenoses supported by real-time MR imaging and intra-arterial MR angiography is feasible with commercially available materials.

Cited by 43 publications

References 16 publications

An overview on the advances in cardiovascular interventional MR imaging

An overview on the advances in cardiovascular interventional MR imaging

MR‐guided intravascular interventions: Techniques and applications

MR-guided endovascular interventions: a comprehensive review on techniques and applications

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