MR imaging-guided stent placement in iliac arterial stenoses: a feasibility study

To assess the feasibility of magnetic resonance (MR) imaging-guided stent placement in iliac arterial stenoses.

Thirteen patients with 14 iliac arterial stenoses were examined prospectively. Angioplasty was performed through a femoral sheath by using a conventional 1.5-T MR imaging system. Stents and catheters were visualized on the basis of their artifacts. Nitinol stents were placed with gradient-echo MR imaging guidance. Angioplasty balloons were inflated with gadolinium-based contrast material. Results were evaluated clinically and with both digital subtraction angiography (DSA) and contrast material-enhanced MR angiography.

Ten of 13 patients were treated with technical success by using MR imaging-guided intervention alone. Three patients were treated with additional fluoroscopic guidance, because complications (ie, panic attack, subintimal recanalization, and stent misplacement) occurred with MR guidance. The quality of the postinterventional contrast-enhanced MR angiograms of three of 12 lesions with stents was limited owing to stent-induced signal loss of the lumen. The mean stenosis degree after stent placement was significantly higher at contrast-enhanced MR angiography than at DSA (24.6% vs 6.2%). The mean MR imaging-guided procedure time was 74 minutes.

MR imaging-guided stent placement in iliac arteries is feasible in select patients. The presented technique has limitations-that is, long procedure times, lack of real-time monitoring, and stent artifacts-that necessitate further modifications before it can be recommended for clinical use.