title: Feasibility of real-time magnetic resonance-guided angioplasty and stenting of renal arteries in vitro and in Swine, using a new polyetheretherketone-based magnetic resonance-compatible guidewire.
abstract: OBJECTIVE
  Demonstrate the usability of a new polyetheretherketone (PEEK)-based MR-compatible guidewire for renal artery catheterization, angioplasty, and stenting under MR-guidance using MR-visible markers, in vitro and in vivo.
  
  
  METHODS
  The new 0.035'' guidewire with fiber-reinforced PEEK core, a soft tip, and a hydrophilic coating was used. Paramagnetic markings were coated on the wire and nonbraided catheters for passive visualization. Bending stiffness of the guidewire was compared with available hydrophilic guidewires (Terumo Glidewire Stiff and Standard). A human aortic silicon phantom and 2 pigs were used. The study was animal care and use approved by the committee. Under MR-guidance, renal arteries were catheterized, balloon angioplasty was performed, and balloon expandable renal artery stents were deployed in vivo. Post mortem autopsy was performed. Guidewire visibility, pushability, steerability, and device-support capabilities of the marked guidewire were qualitatively assessed. Procedure times were recorded.
  
  
  RESULTS
  Bending stiffness of the new PEEK-based wire was comparable with Standard Glidewire. In vitro and in vivo guidewire guidance, catheter configuration, renal artery catheterization, and balloon angioplasty were successful. In pigs, stent deployments were successful in both renal arteries. Autopsy revealed acceptable stent positioning. Guidewire visibility through applied markers was acceptable. Steerability, pushability, and device support were good in vitro and in vivo.
  
  
  CONCLUSIONS
  The PEEK-based guide allows percutaneous MR-guided renal artery angioplasty and stenting with sufficient visibility, good steerability, pushability, and device support.
authors.affiliation: Division of Interventional Radiology, Institute of Radiology, University Hospital Basel, Basel, Switzerland. skos@gmx.de
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kos
authors.forename: Rolf
authors.initials: R
authors.lastname: Huegli
authors.forename: Eugen
authors.initials: E
authors.lastname: Hofmann
authors.forename: Harald H
authors.initials: HH
authors.lastname: Quick
authors.forename: Hilmar
authors.initials: H
authors.lastname: Kuehl
authors.forename: Stephanie
authors.initials: S
authors.lastname: Aker
authors.forename: Gernot M
authors.initials: GM
authors.lastname: Kaiser
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Borm
authors.forename: Augustinus L
authors.initials: AL
authors.lastname: Jacob
authors.forename: Deniz
authors.initials: D
authors.lastname: Bilecen
mesh_terms: D017130:Angioplasty / Q000379:methods*; D000818:Animals; D001577:Benzophenones; D006801:Humans; D007659:Ketones; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D019047:Phantoms, Imaging; D011092:Polyethylene Glycols; D011108:Polymers; D012078:Renal Artery Obstruction / Q000601:surgery*; D015607:Stents; D013552:Swine
chemical_list: D001577:Benzophenones; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols