Feasibility of stent placement in carotid arteries with real-time MR imaging guidance in pigs.

All examinations were performed with approval from the institutional animal care and use committee of Columbia University. To assess the feasibility of real-time magnetic resonance (MR) imaging-guided neurovascular intervention in a swine model, the authors placed stents in the carotid arteries of five domestic pigs. Seven-French vascular sheaths were placed in the target carotid arteries via femoral access by using active MR tracking. Ten nitinol stents (8-10 x 20-40 mm) were successfully deployed in the target segments of carotid arteries bilaterally. MR imaging and necropsy findings confirmed stent position. Necropsy revealed no gross vascular injury. Study results demonstrated the feasibility of performing real-time MR imaging-guided neurovascular intervention by using an active-tracking technique in an animal model.

[1]  F. Korosec,et al.  Real-time MR imaging-guided passive catheter tracking with use of gadolinium-filled catheters. , 2000, Journal of vascular and interventional radiology : JVIR.

[2]  J. Hirsch,et al.  An Integrated Functional Magnetic Resonance Imaging Procedure for Preoperative Mapping of Cortical Areas Associated with Tactile, Motor, Language, and Visual Functions , 2000, Neurosurgery.

[3]  W. Mali,et al.  MRA flow quantification in patients with a symptomatic internal carotid artery occlusion. The Dutch EC-IC Bypass Study Group. , 1997, Stroke.

[4]  Warren J Manning,et al.  Magnetic Resonance–Guided Coronary Artery Stent Placement in a Swine Model , 2002, Circulation.

[5]  J. Finn,et al.  Real-Time Magnetic Resonance Imaging-Guided Coronary Catheterization in Swine , 2003, Circulation.

[6]  M. McLean,et al.  Continuing ischemic damage after acute middle cerebral artery infarction in humans demonstrated by short-echo proton spectroscopy. , 1995, Stroke.

[7]  J. Ranjeva,et al.  Metabolic Counterpart of Decreased Apparent Diffusion Coefficient During Hyperacute Ischemic Stroke: A Brain Proton Magnetic Resonance Spectroscopic Imaging Study , 2003, Stroke.

[8]  D Chien,et al.  MR diffusion imaging of cerebral infarction in humans. , 1992, AJNR. American journal of neuroradiology.

[9]  R J Seitz,et al.  Diffusion- and perfusion-weighted MRI. The DWI/PWI mismatch region in acute stroke. , 1999, Stroke.

[10]  Max A Viergever,et al.  Passive tracking exploiting local signal conservation: The white marker phenomenon , 2003, Magnetic resonance in medicine.

[11]  J. Holmes,et al.  Lifetime cost of stroke in the United States. , 1996, Stroke.

[12]  S. Warach,et al.  Magnetic Resonance Imaging of Acute Stroke , 1998, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[13]  R W Günther,et al.  Real-time MR Guidance for inferior vena cava filter placement in an animal model. , 2001, Journal of vascular and interventional radiology : JVIR.

[14]  J. Alger,et al.  Beyond Mismatch: Evolving Paradigms in Imaging the Ischemic Penumbra With Multimodal Magnetic Resonance Imaging , 2003, Stroke.

[15]  Joseph P. Broderick,et al.  Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. , 1995 .

[16]  Clemens Bos,et al.  Placement of an inferior vena cava filter in a pig guided by high‐resolution MR fluoroscopy at 1.5 T , 2000, Journal of magnetic resonance imaging : JMRI.

[17]  N Chakfé,et al.  Endovascular procedures under near-real-time magnetic resonance imaging guidance: an experimental feasibility study. , 2000, Journal of vascular surgery.

[18]  P. Adeleine,et al.  Baseline Magnetic Resonance Imaging Parameters and Stroke Outcome in Patients Treated by Intravenous Tissue Plasminogen Activator , 2003, Stroke.

[19]  Richard Frayne,et al.  Reliability of Assessing Percentage of Diffusion-Perfusion Mismatch , 2003, Stroke.

[20]  Ting-Yim Lee,et al.  Correlation of early dynamic CT perfusion imaging with whole-brain MR diffusion and perfusion imaging in acute hemispheric stroke. , 2003, AJNR. American journal of neuroradiology.

[21]  Ergin Atalar,et al.  MRI‐guided coronary catheterization and PTCA: A feasibility study on a dog model , 2003, Magnetic resonance in medicine.

[22]  M A Viergever,et al.  Visualization of dedicated catheters using fast scanning techniques with potential for MR‐guided vascular interventions , 1996, Magnetic resonance in medicine.

[23]  Xiaoming Yang.  Imaging of vascular gene therapy. , 2003, Radiology.

[24]  Wei Li,et al.  Fast magnetic resonance diffusion‐weighted imaging of acute human stroke , 1992, Neurology.

[25]  T Schaeffter,et al.  Real‐time MR fluoroscopy for MR‐guided iliac artery stent placement , 2000, Journal of magnetic resonance imaging : JMRI.

[26]  N J Pelc,et al.  A truly hybrid interventional MR/X‐ray system: Feasibility demonstration , 2001, Journal of magnetic resonance imaging : JMRI.

[27]  J. Röther.  CT and MRI in the diagnosis of acute stroke and their role in thrombolysis. , 2001, Thrombosis research.

[28]  Mark E Ladd,et al.  Interventional MRA using actively visualized catheters, TrueFISP, and real‐time image fusion , 2003, Magnetic resonance in medicine.

[29]  C. Yuan,et al.  Carotid atherosclerotic wall imaging by MRI. , 2002, Neuroimaging clinics of North America.

[30]  Charles L Dumoulin,et al.  Transfemoral catheterization of carotid arteries with real-time MR imaging guidance in pigs. , 2005, Radiology.

[31]  R. Higashida,et al.  Intra-arterial Prourokinase for Acute Ischemic Stroke: The PROACT II Study: A Randomized Controlled Trial , 1999 .

[32]  D Saloner,et al.  Assessment of carotid artery stenosis by MR angiography: comparison with x-ray angiography and color-coded Doppler ultrasound. , 1992, AJNR. American journal of neuroradiology.

[33]  F. Snaps,et al.  Relevant radiological anatomy of the pig as a training model in interventional radiology , 1998, European Radiology.

[34]  Pietro Andreone,et al.  Transarterial chemoembolization for unresectable hepatocellular carcinoma: meta-analysis of randomized controlled trials. , 2002, Radiology.

[35]  Martin G. Mack,et al.  Hybrid MR interventional imaging system: combined MR and angiography suites with single interactive table. Feasibility study in vascular liver tumor procedures , 2002, European Radiology.

[36]  U. Salvolini,et al.  MR angiography in carotid stenosis: a comparison of three techniques. , 1998, European journal of radiology.

[37]  Tobias G. Noll,et al.  Device visualization for interventional MRI using local magnetic fields: basic theory and its application to catheter visualization , 1998, IEEE Transactions on Medical Imaging.

[38]  B. Rosen,et al.  High resolution measurement of cerebral blood flow using intravascular tracer bolus passages. Part II: Experimental comparison and preliminary results , 1996, Magnetic resonance in medicine.

[39]  S. Souza,et al.  Real‐time position monitoring of invasive devices using magnetic resonance , 1993, Magnetic resonance in medicine.

[40]  M. Kaste,et al.  Economic burden of stroke and the evaluation of new therapies. , 1998, Public health.

[41]  Alastair Martin,et al.  Magnetic Resonance–Guided Cardiac Catheterization in a Swine Model of Atrial Septal Defect , 2003, Circulation.

[42]  R. McClure,et al.  Carotid angioplasty and stenting versus carotid endarterectomy: randomized trial in a community hospital. , 2001, Journal of the American College of Cardiology.

[43]  M A Viergever,et al.  MR-guided endovascular interventions: susceptibility-based catheter and near-real-time imaging technique. , 1997, Radiology.

[44]  Werner Hacke,et al.  Imaging-Based Decision Making in Thrombolytic Therapy for Ischemic Stroke: Present Status , 2003, Stroke.

[45]  H. Yonas,et al.  The acetazolamide challenge: imaging techniques designed to evaluate cerebral blood flow reserve. , 1989, AJR. American journal of roentgenology.

[46]  L H Schwamm,et al.  Regional ischemia and ischemic injury in patients with acute middle cerebral artery stroke as defined by early diffusion-weighted and perfusion-weighted MRI. , 1998, Stroke.

[47]  Reto Meuli,et al.  CT perfusion scanning with deconvolution analysis: pilot study in patients with acute middle cerebral artery stroke. , 2002, Radiology.

[48]  Carotid Artery Stenting: Current Status and Future Directions , 2003, Vascular and endovascular surgery.

[49]  F. Buonanno,et al.  Predicting Tissue Outcome in Acute Human Cerebral Ischemia Using Combined Diffusion- and Perfusion-Weighted MR Imaging , 2001, Stroke.

[50]  N. Pelc,et al.  Qualitative phase contrast MRA in the normal and abnormal circle of Willis. , 1993, AJNR. American journal of neuroradiology.

[51]  E. Atalar,et al.  Magnetic Resonance Imaging Permits In Vivo Monitoring of Catheter-Based Vascular Gene Delivery , 2001, Circulation.

[52]  Peter Koch,et al.  Development of a decision-analytic model of stroke care in the United States and Europe. , 2002, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[53]  C J Bakker,et al.  Passive tracking of catheters and guidewires by contrast‐enhanced MR fluoroscopy , 2001, Magnetic resonance in medicine.

[54]  H Steinmetz,et al.  Magnetic resonance imaging of regional cerebral blood oxygenation changes under acetazolamide in carotid occlusive disease. , 1995, Stroke.

[55]  R Frayne,et al.  Endovascular treatment of experimental canine aneurysms: feasibility with MR imaging guidance. , 2000, Radiology.

[56]  J. Carr,et al.  Passive catheter tracking using MRI: Comparison of conventional and magnetization‐prepared FLASH , 2002, Journal of magnetic resonance imaging : JMRI.