Real-time magnetic resonance imaging - guided coronary intervention in a porcine model

Sci Rep. 2019 Jun 17;9(1):8663. doi: 10.1038/s41598-019-45154-7.

Abstract

X-ray fluoroscopy is the gold standard for coronary diagnostics and intervention. Magnetic resonance imaging is a radiation-free alternative to x-ray with excellent soft tissue contrast in arbitrary slice orientation. Here, we assessed real-time MRI-guided coronary interventions from femoral access using newly designed MRI technologies. Six Goettingen minipigs were used to investigate coronary intervention using real-time MRI. Catheters were custom-designed and equipped with an active receive tip-coil to improve visibility and navigation capabilities. Using modified standard clinical 5 F catheters, intubation of the left coronary ostium was successful in all animals. For the purpose of MR-guided coronary interventions, a custom-designed 8 F catheter was used. In spite of the large catheter size, and therefore limited steerability, intubation of the left coronary ostium was successful in 3 of 6 animals within seconds. Thereafter, real-time guided implantation of a non-metallic vascular scaffold into coronary arteries was possible. This study demonstrates that real-time MRI-guided coronary catheterization and intervention via femoral access is possible without the use of any contrast agents or radiation, including placement of non-metallic vascular scaffolds into coronary arteries. Further development, especially in catheter and guidewire technology, will be required to drive forward routine MR-guided coronary interventions as an alternative to x-ray fluoroscopy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Catheters
  • Coronary Vessels / diagnostic imaging*
  • Equipment Design*
  • Magnetic Resonance Imaging, Interventional / instrumentation
  • Magnetic Resonance Imaging, Interventional / methods*
  • Male
  • Percutaneous Coronary Intervention / instrumentation
  • Percutaneous Coronary Intervention / methods*
  • Swine
  • Swine, Miniature