Feasibility of Real-Time Magnetic Resonance-Guided Angioplasty and Stenting of Renal Arteries in Vitro and in Swine, Using a New Polyetheretherketone-Based Magnetic Resonance-Compatible Guidewire

作者:Kos Sebastian*; Huegli Rolf; Hofmann Euggen; Quick Harald H; Kuehl Hilmar; Aker Stephanie; Kaiser Gernot M; Borm Paul J; Jacob Augustinus L; Bilecen Deniz
来源:Investigative Radiology, 2009, 44(4): 234-241.
DOI:10.1097/rli.0b013e31819b00f1

摘要

Objectives: Demonstrate the usability of a new polyetheretherketone (PEEK)-based MR-compatible guidewire for renal artery catheterization, angioplasty, and stenting under MR-guidance using MR-visible markers, in vitro and in vivo. Material and Methods: The new 0.035" guidewire with fiber-rein forced PEEK core, a soft tip, and a hydrophilic coating was used. Paramagnetic markings were coated on the wire and nonbraided catheters for passive visualization. Bending stiffness of the guidewire was compared with available hydrophilic guidewires (Terumo Glidewire Stiff and Standard). A human aortic silicon phantom and 2 pigs were used. The study was animal care and use approved by the committee. Under MR-guidance, renal arteries were catheterized, balloon angioplasty was performed, and balloon expandable renal artery stents were deployed in vivo. Post mortem autopsy was performed. Guidewire visibility, pushability, steerability, and device-support capabilities of the marked guidewire were qualitatively assessed. Procedure times were recorded. Results: Bending stiffness of the new PEEK-based wire was comparable with Standard Glidewire. In vitro and in vivo guidewire guidance, catheter configuration, renal artery catheterization, and balloon angioplasty were successful. In pigs, stent deployments were successful in both renal arteries. Autopsy revealed acceptable stent positioning. Guidewire visibility through applied markers was acceptable. Steerability, pushability, and device support were good in vitro and in vivo. Conclusions: The PEEK-based guide allows percutaneous MR-guided renal artery angioplasty and stenting with sufficient visibility, good steerability, pushability, and device support.

  • 出版日期2009-4