Evaluation of MR/Fluoroscopy–guided portosystemic shunt creation in a swine model

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buir.contributor.authorAtalar, Ergin
dc.citation.epage1173en_US
dc.citation.issueNumber7en_US
dc.citation.spage1165en_US
dc.citation.volumeNumber17en_US
dc.contributor.authorArepally, A.en_US
dc.contributor.authorKarmarkar, P. V.en_US
dc.contributor.authorQian, D.en_US
dc.contributor.authorBarnett, B.en_US
dc.contributor.authorAtalar, Erginen_US
dc.date.accessioned2016-02-08T10:18:47Z
dc.date.available2016-02-08T10:18:47Z
dc.date.issued2006en_US
dc.departmentDepartment of Electrical and Electronics Engineeringen_US
dc.departmentNational Magnetic Resonance Research Center (UMRAM)en_US
dc.description.abstractPURPOSE: To evaluate three different percutaneous portosystemic shunts created with magnetic resonance (MR) imaging and fluoroscopy guidance in a swine model. MATERIALS AND METHODS: In stage 1 of the experiment, an active MR intravascular needle system was created for needle tracking and extracaval punctures. Twenty inferior vena cava (IVC)/superior mesenteric vein (SMV)/portal vein (PV) punctures were performed in 10 swine (weight, 40-45 kg) in a 1.5-T short-bore interventional MR imager. With use of a real-time MR imaging sequence, the needle was guided through the IVC and into the SMV or PV (N = 20 punctures). After confirmation, a wire was advanced into the portal venous system under MR imaging guidance (N = 20). In stage 2, animals were transferred to the radiographic fluoroscopy suite for deployment of shunts. Three different shunts were evaluated in this study: (i) a commercial stent-graft, (ii) a prototype bridging stent, and (iii) a prototype nitinol vascular anastomotic device. Postprocedural necropsy was performed in all animals. RESULTS: Successful MR-guided IVC/SMV punctures were performed in all 20 procedures (100%). All three shunts were deployed. Stent-grafts had the poorest mechanism for securing a shunt. The vascular anastomotic device and the bridging stent had more secure anchoring mechanisms but also had higher technical failure rates (50% and 40%, respectively). When deployed successfully, the vascular anastomotic device resulted in no bleeding at the sites of punctures at necropsy. CONCLUSION: Percutaneous shunts and vascular anastomoses between the portal mesenteric venous system and IVC were successfully created with use of a combination of MR imaging and conventional fluoroscopy for guidance.en_US
dc.identifier.doi10.1097/01.RVI.0000228493.07075.FCen_US
dc.identifier.eissn1535-7732
dc.identifier.issn1051-0443
dc.identifier.urihttp://hdl.handle.net/11693/23764
dc.language.isoEnglishen_US
dc.publisherElsevier Inc.en_US
dc.relation.isversionofhttp://doi.org/10.1097/01.RVI.0000228493.07075.FCen_US
dc.source.titleJournal of Vascular and Interventional Radiologyen_US
dc.titleEvaluation of MR/Fluoroscopy–guided portosystemic shunt creation in a swine modelen_US
dc.typeArticleen_US

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Department of Electrical and Electronics Engineering
National Magnetic Resonance Research Center (UMRAM)