Preclinical feasibility of a technology framework for MRI-guided iliac angioplasty

Martin Rube (Lead / Corresponding author), Fabiola Fernandez-Gutierrez, Benjamin F. Cox, Andrew B. Holbrook, J. Graeme Houston, Richard D. White, Helen McLeod, Mahsa Fatahi, Andreas Melzer

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    2 Citations (Scopus)

    Abstract

    Purpose Interventional MRI has significant potential for image guidance of iliac angioplasty and related vascular procedures. A technology framework with in-room image display, control, communication and MRI-guided intervention techniques was designed and tested for its potential to provide safe, fast and efficient MRI-guided angioplasty of the iliac arteries.
    Methods
    A 1.5-T MRI scanner was adapted for interactive imaging during endovascular procedures using new or modified interventional devices such as guidewires and catheters. A perfused vascular phantom was used for testing. Pre-, intra- and post-procedural visualization and measurement of vascular morphology and flow was implemented. A detailed analysis of X-ray fluoroscopic angiography workflow was conducted and applied. Two interventional radiologists and one physician in training performed 39 procedures. All procedures were timed and analyzed.
    Results MRI-guided iliac angioplasty procedures were successfully performed with progressive adaptation of techniques and workflow. The workflow, setup and protocol enabled a reduction in table time for a dedicated MRI-guided procedure to 6 min 33 s with a mean procedure time of 9 min 2 s, comparable to the mean procedure time of 8 min 42 s for the standard X-ray-guided procedure.
    Conclusions MRI-guided iliac vascular interventions were found to be feasible and practical using this framework and optimized workflow. In particular, the real-time flow analysis was found to be helpful for pre- and post-interventional assessments. Design optimization of the catheters and in vivo experiments are required before clinical evaluation.
    Original languageEnglish
    Pages (from-to)637-650
    Number of pages14
    JournalInternational Journal of Computer Assisted Radiology and Surgery
    Volume10
    Issue number5
    Early online date8 Aug 2014
    DOIs
    Publication statusPublished - May 2015

    Keywords

    • Interventional MRI workflow
    • Device localization
    • Catheter tracking
    • MR-guided balloon angioplasty

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