MR imaging-guided stent placement in iliac arterial stenoses: A feasibility study

PURPOSE: To assess the feasibility of magnetic resonance (MR) imaging-guide d stent placement in iliac arterial stenoses. MATERIALS AND METHODS: Thirteen patients with 14 iliac arterial stenoses we re examined prospectively. Angioplasty was performed through a femoral shea th by using a conventional 1.5-T MR imaging system. Stents and catheters we re visualized on the basis of their artifacts. Nitinol stents were placed w ith gradient-echo MR imaging guidance. Angioplasty balloons were inflated w ith gadolinium-based contrast material. Results were evaluated clinically a nd with both digital subtraction angiography (DSA) and contrast material-en hanced MR angiography. RESULTS: Ten of 13 patients were treated with technical success by using MR imaging-guided intervention alone. Three patients were treated with additi onal fluoroscopic guidance, because complications tie, panic attack, subint imal recanalization, and stent misplacement) occurred with MR guidance. The quality of the postinterventional contrast-enhanced MR angiograms of three of 12 lesions with stents was limited owing to stent-induced signal loss o f the lumen. The mean stenosis degree after stent placement was significant ly higher at contrast-enhanced MR angiography than at DSA (24.6% vs 6.2%). The mean MR imaging-guided procedure time was 74 minutes. CONCLUSION: MR imaging-guided stent placement in iliac arteries is feasible in select patients. The presented technique has limitations-that is, long procedure times, lack of real-time monitoring, and stent artifacts-that nec essitate further modifications before it can be recommended for clinical us e.