Magnetic resonance guided renal denervation using active tracking: first in vivo experience in Swine

Interventional cardiovascular magnetic resonance (iCMR) might evolve as a technique to improve procedural success rates in cardiovascular interventions by combining intraprocedural guidance and simultaneous lesion imaging. The objective of the present study was to prove feasibility and estimate safe...

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Veröffentlicht in:The International Journal of Cardiovascular Imaging 2018-03, Vol.34 (3), p.431-439
Hauptverfasser: Bönner, F., Haberkorn, S., Behm, P., Schnackenburg, B., Krüger, S., Weiss, S., Meyer, C., Kelm, M., Neizel-Wittke, M.
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container_title The International Journal of Cardiovascular Imaging
container_volume 34
creator Bönner, F.
Haberkorn, S.
Behm, P.
Schnackenburg, B.
Krüger, S.
Weiss, S.
Meyer, C.
Kelm, M.
Neizel-Wittke, M.
description Interventional cardiovascular magnetic resonance (iCMR) might evolve as a technique to improve procedural success rates in cardiovascular interventions by combining intraprocedural guidance and simultaneous lesion imaging. The objective of the present study was to prove feasibility and estimate safety of renal sympathetic denervation guided by real-time iCMR using active tracking. Six pigs were examined in a 1.5 T MRI-System (Achieva, Philips Healthcare, Best, Netherlands) equipped with non-invasive hemodynamic control and in-room monitors displaying an interventional software platform [Interventional MRI Suite (iSuite), Philips Research, Hamburg, Germany]. MR-guided renal denervation was performed using a MR conditional non-irrigated ablation catheter with active tracking (Imricor, Burnsville, MN, USA). Real-time imaging for device guidance was performed with a TFE sequence, vessel patency was assessed with a 3D non-contrast angiography and velocity encoded imaging. Oedema of the renal artery was visualized by a high-resolution T2 SPIR sequence. Renal sympathetic denervation was feasible in all cases with survival of all animals. Non-contrast angiography displayed renal artery patency accompanied by equal flow conditions before and after the ablation in all cases as measured by velocity encoded imaging. Oedema imaging displayed a significant increase in relative signal intensity at renal artery ablations sites pre and post intervention (p 
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The objective of the present study was to prove feasibility and estimate safety of renal sympathetic denervation guided by real-time iCMR using active tracking. Six pigs were examined in a 1.5 T MRI-System (Achieva, Philips Healthcare, Best, Netherlands) equipped with non-invasive hemodynamic control and in-room monitors displaying an interventional software platform [Interventional MRI Suite (iSuite), Philips Research, Hamburg, Germany]. MR-guided renal denervation was performed using a MR conditional non-irrigated ablation catheter with active tracking (Imricor, Burnsville, MN, USA). Real-time imaging for device guidance was performed with a TFE sequence, vessel patency was assessed with a 3D non-contrast angiography and velocity encoded imaging. Oedema of the renal artery was visualized by a high-resolution T2 SPIR sequence. Renal sympathetic denervation was feasible in all cases with survival of all animals. Non-contrast angiography displayed renal artery patency accompanied by equal flow conditions before and after the ablation in all cases as measured by velocity encoded imaging. Oedema imaging displayed a significant increase in relative signal intensity at renal artery ablations sites pre and post intervention (p &lt; 0.05). The histologic examination revealed no signs of perforation or bleeding, while sufficient ablation lesions could be depicted. MR-guided renal sympathetic denervation using active tracking is feasible and the initial data suggest safety of this procedure. 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The objective of the present study was to prove feasibility and estimate safety of renal sympathetic denervation guided by real-time iCMR using active tracking. Six pigs were examined in a 1.5 T MRI-System (Achieva, Philips Healthcare, Best, Netherlands) equipped with non-invasive hemodynamic control and in-room monitors displaying an interventional software platform [Interventional MRI Suite (iSuite), Philips Research, Hamburg, Germany]. MR-guided renal denervation was performed using a MR conditional non-irrigated ablation catheter with active tracking (Imricor, Burnsville, MN, USA). Real-time imaging for device guidance was performed with a TFE sequence, vessel patency was assessed with a 3D non-contrast angiography and velocity encoded imaging. Oedema of the renal artery was visualized by a high-resolution T2 SPIR sequence. Renal sympathetic denervation was feasible in all cases with survival of all animals. Non-contrast angiography displayed renal artery patency accompanied by equal flow conditions before and after the ablation in all cases as measured by velocity encoded imaging. Oedema imaging displayed a significant increase in relative signal intensity at renal artery ablations sites pre and post intervention (p &lt; 0.05). The histologic examination revealed no signs of perforation or bleeding, while sufficient ablation lesions could be depicted. MR-guided renal sympathetic denervation using active tracking is feasible and the initial data suggest safety of this procedure. MR-guided renal sympathetic denervation offers the inherent strength of high soft tissue contrast thereby providing target information without the use of iodinated contrast agents or radiation.</description><subject>Ablation</subject><subject>Angiography</subject><subject>Animals</subject><subject>Biopsy</subject><subject>Bleeding</subject><subject>Cardiac Imaging</subject><subject>Cardiology</subject><subject>Catheter Ablation - adverse effects</subject><subject>Coding</subject><subject>Contrast agents</subject><subject>Denervation</subject><subject>Edema</subject><subject>Feasibility Studies</subject><subject>Health care</subject><subject>Image Interpretation, Computer-Assisted</subject><subject>Imaging</subject><subject>Kidney - blood supply</subject><subject>Kidneys</subject><subject>Lesions</subject><subject>Livestock</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging, Interventional - adverse effects</subject><subject>Medical imaging</subject><subject>Medical instruments</subject><subject>Medicine</subject><subject>Medicine &amp; 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The objective of the present study was to prove feasibility and estimate safety of renal sympathetic denervation guided by real-time iCMR using active tracking. Six pigs were examined in a 1.5 T MRI-System (Achieva, Philips Healthcare, Best, Netherlands) equipped with non-invasive hemodynamic control and in-room monitors displaying an interventional software platform [Interventional MRI Suite (iSuite), Philips Research, Hamburg, Germany]. MR-guided renal denervation was performed using a MR conditional non-irrigated ablation catheter with active tracking (Imricor, Burnsville, MN, USA). Real-time imaging for device guidance was performed with a TFE sequence, vessel patency was assessed with a 3D non-contrast angiography and velocity encoded imaging. Oedema of the renal artery was visualized by a high-resolution T2 SPIR sequence. Renal sympathetic denervation was feasible in all cases with survival of all animals. Non-contrast angiography displayed renal artery patency accompanied by equal flow conditions before and after the ablation in all cases as measured by velocity encoded imaging. Oedema imaging displayed a significant increase in relative signal intensity at renal artery ablations sites pre and post intervention (p &lt; 0.05). The histologic examination revealed no signs of perforation or bleeding, while sufficient ablation lesions could be depicted. MR-guided renal sympathetic denervation using active tracking is feasible and the initial data suggest safety of this procedure. MR-guided renal sympathetic denervation offers the inherent strength of high soft tissue contrast thereby providing target information without the use of iodinated contrast agents or radiation.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>28956200</pmid><doi>10.1007/s10554-017-1244-6</doi><tpages>9</tpages></addata></record>
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subjects Ablation
Angiography
Animals
Biopsy
Bleeding
Cardiac Imaging
Cardiology
Catheter Ablation - adverse effects
Coding
Contrast agents
Denervation
Edema
Feasibility Studies
Health care
Image Interpretation, Computer-Assisted
Imaging
Kidney - blood supply
Kidneys
Lesions
Livestock
Magnetic resonance imaging
Magnetic Resonance Imaging, Interventional - adverse effects
Medical imaging
Medical instruments
Medicine
Medicine & Public Health
Models, Animal
Original Paper
Perforation
Radiation
Radiology
Real time
Renal artery
Renal Artery - diagnostic imaging
Renal Artery - innervation
Renal Artery - pathology
Resonance
Safety
Swine
Swine, Miniature
Sympathectomy - adverse effects
Sympathectomy - methods
Sympathetic Nervous System - surgery
Time Factors
Tracking
Veins & arteries
Velocity
title Magnetic resonance guided renal denervation using active tracking: first in vivo experience in Swine
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