Interventional magnetic resonance imaging guided carotid embolectomy using a novel resonant marker catheter: demonstration of preclinical feasibility
| Autor: | Teri Moore, Daniel L Cooke, Jay F. Yu, Steven W. Hetts, Caroline D. Jordan, J. Yang, Maythem Saeed, Alastair J. Martin, Matthew D Alexander, A Nicholson, Andrew Chu, Carol Stillson, Fabio Settecase, Aaron D. Losey, Sravani Kondapavulur, Dave Barry, Andre M. Cote, David McCoy, Mark W. Wilson |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Catheters Interventional magnetic resonance imaging Swine medicine.medical_treatment Biomedical Engineering Embolectomy 030204 cardiovascular system & hematology Article Catheterization Analytical Chemistry 03 medical and health sciences 0302 clinical medicine Clinical Research InterventionalMRI medicine Animals Molecular Biology Interventional MRI screening and diagnosis business.industry Cerebral infarction Wireless resonant marker Thrombolysis Blood flow Materials Engineering medicine.disease Arterial occlusion Magnetic Resonance Imaging Stroke Catheter Detection Carotid Arteries Carotid artery occlusion Biomedical Imaging Radiology business 030217 neurology & neurosurgery 4.2 Evaluation of markers and technologies |
| Zdroj: | Biomedical microdevices, vol 19, iss 4 |
| Popis: | To assess the visualization and efficacy of a wireless resonant circuit (wRC) catheter system for carotid artery occlusion and embolectomy under real-time MRI guidance in vivo, and to compare MR imaging modality with x-ray for analysis of qualitative physiological measures of blood flow at baseline and after embolectomy. The wRC catheter system was constructed using a MR compatible PEEK fiber braided catheter (Penumbra, Inc, Alameda, CA) with a single insulated longitudinal copper loop soldered to a printed circuit board embedded within the catheter wall. In concordance with IACUC protocol (AN103047), in vivo carotid artery navigation and embolectomy were performed in four farm pigs (40-45 kg) under real-time MRI at 1.5T. Industry standard clots were introduced in incremental amounts until adequate arterial occlusion was noted in a total of n=13 arteries. Baseline vasculature and restoration of blood flow were confirmed via MR and x-ray imaging, and graded by the Thrombolysis in Cerebral Infarction (TICI) scale. Wilcoxon signed-rank tests were used to analyze differences in recanalization status between DSA and MRA imaging. Successful recanalizations (TICI 2b/3) were compared to clinical rates reported in literature via binomial tests. The wRC catheter system was visible both on 5° sagittal bSSFP and coronal GRE sequence. Successful recanalization was demonstrated in 11 of 13 occluded arteries by DSA analysis and 8 of 13 by MRA. Recanalization rates based on DSA (0.85) and MRA (0.62) were not significantly different from the clinical rate of mechanical aspiration thrombectomy reported in literature. Lastly, a Wilcoxon signed rank test indicated no significant difference between TICI scores analyzed by DSA and MRA. With demonstrated compatibility and visualization under MRI, the wRC catheter system is effective for in vivo endovascular embolectomy, suggesting progress towards clinical endovascular interventional MRI. |
| Databáze: | OpenAIRE |
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