Image-Guided and -Monitored Renal Artery Stenting Using Only Mri

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Abstract

Purpose:

To demonstrate the ability of a unique interventional MR system to be used safely and effectively as the only imaging modality for all phases of MR-guided stent-supported angioplasty.

Materials and Methods:

An experimental disease model of renal stenosis was created in six pigs. An interventional MR system, which employed previously reported tools for real-time catheter tracking with automated scan-plane positioning, adaptive image parameters, and radial true–FISP imaging with steady-state precession (True-FISP) imaging coupled with a high-speed reconstruction technique, was then used to guide all phases of the intervention, including: guidewire and catheter insertion, stent deployment, and confirmation of therapeutic success. Pre- and postprocedural X-ray imaging was used as a gold standard to validate the experimental results.

Results:

All of the stent-supported angioplasty interventions were a technical success and were performed without complications. The average postoperative residual stenosis was 14.9%. The image guidance enabled the stents to be deployed with an accuracy of 0.98 ± 0.69 mm. Additionally, using this interventional MRI system to guide renal artery stenting significantly reduces the procedure time, as compared to using X-ray fluoroscopy.

Conclusion:

This study has clearly demonstrated the first successful treatment of renal artery stenting in an experimental animal model solely under MRI guidance and monitoring.

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