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Delivery and assessment of endovascular stents to repair aortic coarctation using MR and X‐ray imaging
Author(s) -
Saeed Maythem,
Henk Christine B.,
Weber Oliver,
Martin Alastair,
Wilson Mark,
Shunk Kendrick,
Saloner David,
Higgins Charles B.
Publication year - 2006
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.20631
Subject(s) - medicine , stent , radiology , fluoroscopy , coarctation of the aorta , catheter , aorta , aortic repair , surgery , aneurysm
Purpose To investigate the utility of MR and X‐ray imaging for characterizing aortic coarctation and flow, and guiding the endovascular catheter to place a stent to repair the coarctation. Materials and Methods The descending aorta in eight dogs was looped with elastic band and tightened distal to the subclavian artery. Balanced fast field echo (bFFE) and velocity‐encoded cine (VEC) MRI sequences were used for device tracking and measuring aortic flow. A T1‐weighted fast‐field echo sequence (T1‐FFE) was used to visualize the coarctation and roadmap the aorta. Nitinol stents were guided by a nitinol guidewire and placed under MR guidance. Results Aortic coarctation was visible on MR and X‐ray imaging. The procedure success rate was 88%. VEC MRI measured the changes in aortic flow (baseline = 1.3 ± 0.2, coarctation = 0.2 ± 0.02, and stent placement = 0.8 ± 0.1 liters/minute). A significant reduction in iliac blood pressure was measured after coarctation, but it was reversed by stent placement. The stent lumen was visible on X‐ray fluoroscopy, but not on MRI. Conclusion Stent deployment to repair aortic coarctation is feasible under MR guidance. The combined use of MR and X‐ray imaging is effective for anatomic and functional evaluation of aortic coarctation dilation, which may be crucial for optimal therapy. J. Magn. Reson. Imaging 2006. © 2006 Wiley‐Liss, Inc.