Published Online
on January 14, 2002

A more recent version of this article appeared on February 19, 2002

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Submitted on November 5, 2001
Revised on December 11, 2001
Accepted on December 19, 2001

Magnetic Resonance--Guided Coronary Artery Stent Placement in a Swine Model

Elmar Spuentrup MD^*, Alexander Ruebben MD, Tobias Schaeffter PhD, Warren J. Manning MD, Rolf W. Günther MD, and Arno Buecker MD

From the Department of Diagnostic Radiology (E.S., A.R., R.W.G., A.B.), Aachen University of Technology, Aachen, Germany; Philips Research Laboratories (T.S.), Hamburg, Germany; and Departments of Medicine (Cardiovascular Division) and Radiology (W.J.M.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Mass.

^* To whom correspondence should be addressed. E-mail: spuenti{at}rad.rwth-aachen.de.

Background—Magnetic resonance (MR)--guided coronary artery stent placement is a challenging vascular intervention because of the small size of the coronary arteries combined with incessant motion during the respiratory and cardiac cycles. These obstacles necessitate higher temporal and higher spatial resolution real-time MR imaging techniques when compared with interventional peripheral MR angiography.

Methods and Results—A new, ultrafast, real-time MR imaging technique that combines steady-state free precession (SSFP) for high signal-to-noise ratio and radial k-space sampling (rSSFP) for motion artifact suppression was implemented on a 1.5-T clinical whole-body interventional MR scanner. The sliding window reconstruction technique yielded a frame rate of 15/s allowing for data acquisition during free breathing and without cardiac triggering. Eleven balloon-expandable stainless steel coronary stents were placed in both coronary arteries of 7 pigs (40 to 70 kg body weight) using a nitinol guidewire and passive device visualization. Position of the coronary stents was controlled by a navigator-gated free-breathing ECG--triggered three-dimensional SSFP coronary MRA sequence and confirmed visually on the ex vivo heart. The presented real-time MR imaging sequence reliably allowed for high-quality coronary MR fluoroscopy without motion artifacts in all pigs. Ten of 11 coronary stents were correctly placed under MR guidance. One stent dislodged proximally from the left main coronary artery because of too-small balloon size. Stent dislocation was correctly predicted during real-time MR imaging.

Conclusion—The presented approach allows for real-time MR-guided coronary artery stent placement in a swine model.

Key words: magnetic resonance imaging • coronary disease • stents

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