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.
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.
Kos
Sebastian
S
Division of Interventional Radiology, Institute of Radiology, University Hospital Basel, Basel, Switzerland. skos@gmx.de
Huegli
Rolf
R
Hofmann
Eugen
E
Quick
Harald H
HH
Kuehl
Hilmar
H
Aker
Stephanie
S
Kaiser
Gernot M
GM
Borm
Paul J
PJ
Jacob
Augustinus L
AL
Bilecen
Deniz
D
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
D001577:Benzophenones; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols