Abstract
Purpose. To evaluate stent lumen visibility of a large sample of different peripheral arterial (iliac, renal, carotid) stents using magnetic resonance angiography in vitro. Materials and Methods. 21 different stents and one stentgraft (10 nitinol, 7 316L, 2 tantalum, 1 cobalt superalloy, 1 PET + cobalt superalloy, and 1 platinum alloy) were examined in a vessel phantom (vessel diameters ranging from 5 to 13 mm) filled with a solution of Gd-DTPA. Stents were imaged at 1.5 Tesla using a T1-weighted 3D spoiled gradient-echo sequence. Image analysis was performed measuring three categories: Signal intensity in the stent lumen, lumen visibility of the stented lumen, and homogeneity of the stented lumen. The results were classified using a 3-point scale (good, intermediate, and poor results). Results. 7 stents showed good MR lumen visibility (4x nitinol, 2x tantalum, and 1x cobalt superalloy). 9 stents showed intermediate results (5x nitinol, 2x 316L, 1x PET + cobalt superalloy, and 1x platinum alloy) and 6 stents showed poor results (1x nitinol, and 5x 316L). Conclusion. Stent lumen visibility varies depending on the stent material and type. Some products show good lumen visibility which may allow the detection of stenoses inside the lumen, while other products cause artifacts which prevent reliable evaluation of the stent lumen with this technique.
Highlights
Stenoses and occlusion of peripheral arterial vessels are frequently treated with angioplasty and stent insertions.After stent placement there is a risk of in-stent restenosis which can be caused by neointimal growth, vessel wall inflammation or stent thrombosis [1, 2]
In the present study several different peripheral stents were examined in an MRI scanner with current electronics and gradient performance to evaluate their lumen visibility using magnetic resonance angiography (MRA) with a gadoliniumbased contrast agent
The investigated stents are made from different materials (stainless steel (316 L), nitinol, cobalt superalloy, tantalum, and platinum-iridium alloy) and for different areas of application
Summary
Stenoses and occlusion of peripheral arterial vessels are frequently treated with angioplasty and stent insertions. Spiral computed tomography angiography (CTA) is a noninvasive method to evaluate peripheral arteries and has been shown to be an alternative to intra-arterial DSA in different studies [4, 5]. Three-dimensional (3D) contrast enhanced MR angiography (MRA) is another established noninvasive method to examine peripheral arteries. This method has been shown to be a promising noninvasive alternative to DSA and CTA for screening patients suspected of having lower extremity ischemia [6, 7]. The purpose of this study was to evaluate the visibility and potential artifacts of different arterial stents in contrast to enhanced MRA in an experimental setting
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