MRI-guided coronary catheterization and PTCA: A feasibility study on a dog model

Area of Science:

• Cardiovascular Imaging
• Interventional Cardiology
• Medical Device Development

Background:

• X-ray fluoroscopy is the standard for guiding coronary artery interventions.
• Concerns exist regarding cumulative radiation exposure from X-ray use.
• Developing non-ionizing radiation-based guidance methods is a priority.

Purpose of the Study:

• To assess the feasibility of using Magnetic Resonance Imaging (MRI) for guiding coronary artery catheterization and intervention.
• To evaluate MRI-guided percutaneous transluminal coronary angioplasty (PTCA) in a canine model.
• To explore MRI as a potential alternative to X-ray guidance in cardiology.

Main Methods:

• Utilized a prototype 0.014-inch coronary MRI guidewire and a 7 French MRI-guiding catheter in 10 dogs.
• Employed a GE 1.5 T CV/i scanner with surface coils for real-time visualization of catheters and anatomy.
• Used a nongated, single-slice fast gradient-echo sequence for continuous imaging during interventions.

Main Results:

• Successfully performed 15 selective coronary artery catheterizations using MRI guidance.
• Achieved dynamic 2D projection coronary angiography via gadolinium injection through the MRI catheter.
• Completed successful MRI-guided percutaneous transluminal coronary angioplasty (PTCA) in the left anterior and circumflex arteries.

Conclusions:

• Coronary artery catheterization and intracoronary balloon angioplasty are feasible using MRI guidance alone.
• MRI guidance demonstrates potential as a non-fluoroscopic alternative for coronary interventions.
• Further research may establish MRI as a viable option for cardiac interventions, reducing radiation exposure.