Interventional magnetic resonance imaging guided carotid embolectomy using a novel resonant marker catheter: demonstration of preclinical feasibility

• Published in: Biomedical microdevices Vol. 19; no. 4; pp. 88 - 11
• Main Authors: Yang, Jeffrey K., Cote, Andre M., Jordan, Caroline D., Kondapavulur, Sravani, Losey, Aaron D., McCoy, David, Chu, Andrew, Yu, Jay F., Moore, Teri, Stillson, Carol, Settecase, Fabio, Alexander, Matthew D., Nicholson, Andrew, Cooke, Daniel L., Saeed, Maythem, Barry, Dave, Martin, Alastair J., Wilson, Mark W., Hetts, Steven W.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-12-2017; Springer Nature B.V
• Subjects: Animals; Arteries; Biocompatibility; Biological and Medical Physics; Biomedical Engineering and Bioengineering; Biophysics; Blood flow; Braiding; Cardiovascular system; Carotid arteries; Carotid Arteries - diagnostic imaging; Carotid artery; Catheterization - instrumentation; Catheterization - methods; Catheters; Cerebral blood flow; Cerebral infarction; Embolectomy - instrumentation; Embolectomy - methods; Engineering; Engineering Fluid Dynamics; Feasibility studies; In vivo methods and tests; Infarction; Ischemia; Magnetic resonance imaging; Magnetic Resonance Imaging - instrumentation; Magnetic Resonance Imaging - methods; Medical instruments; Nanotechnology; NMR; Nuclear magnetic resonance; Occlusion; Qualitative analysis; Rank tests; Real time; Restoration; Swine; Thrombolysis; Vascular surgery; Veins & arteries; Visualization; Interventional MRI; Stroke; Wireless resonant marker; Embolectomy
• ISSN: 1387-2176; 1572-8781; 1572-8781
• DOI: 10.1007/s10544-017-0225-9

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.