First Magnetic Resonance Imaging-Guided Aortic Stenting and Cava Filter Placement Using a Polyetheretherketone-Based Magnetic Resonance Imaging-Compatible Guidewire in Swine: Proof of Concept

  • Sebastian Kos
  • Rolf Huegli
  • Eugen Hofmann
  • Harald H. Quick
  • Hilmar Kuehl
  • Stephanie Aker
  • Gernot M. Kaiser
  • Paul J. A. Borm
  • Augustinus L. Jacob
  • Deniz Bilecen
Technical Note


The purpose of this study was to demonstrate feasibility of percutaneous transluminal aortic stenting and cava filter placement under magnetic resonance imaging (MRI) guidance exclusively using a polyetheretherketone (PEEK)-based MRI-compatible guidewire. Percutaneous transluminal aortic stenting and cava filter placement were performed in 3 domestic swine. Procedures were performed under MRI-guidance in an open-bore 1.5-T scanner. The applied 0.035-inch guidewire has a PEEK core reinforced by fibres, floppy tip, hydrophilic coating, and paramagnetic markings for passive visualization. Through an 11F sheath, the guidewire was advanced into the abdominal (swine 1) or thoracic aorta (swine 2), and the stents were deployed. The guidewire was advanced into the inferior vena cava (swine 3), and the cava filter was deployed. Postmortem autopsy was performed. Procedural success, guidewire visibility, pushability, and stent support were qualitatively assessed by consensus. Procedure times were documented. Guidewire guidance into the abdominal and thoracic aortas and the inferior vena cava was successful. Stent deployments were successful in the abdominal (swine 1) and thoracic (swine 2) segments of the descending aorta. Cava filter positioning and deployment was successful. Autopsy documented good stent and filter positioning. Guidewire visibility through applied markers was rated acceptable for aortic stenting and good for venous filter placement. Steerability, pushability, and device support were good. The PEEK-based guidewire allows either percutaneous MRI-guided aortic stenting in the thoracic and abdominal segments of the descending aorta and filter placement in the inferior vena cava with acceptable to good device visibility and offers good steerability, pushability, and device support.


Interventional radiology MR-intervention Guide wire PEEK MR-guided stenting MR-compatible Cava filter 



This study was designed as a first-proof concept study in swine. Of course, further investigation is necessary to determine the potential of this new PEEK-based guidewire for MRI-guided arterial and venous interventions.


  1. 1.
    Kos S, Huegli R, Bongartz G et al (2008) MR-guided endovascular interventions: a comprehensive review on techniques and applications. Eur Radiol 18:645–657PubMedCrossRefGoogle Scholar
  2. 2.
    Bock M, Wacker F (2008) MR-guided intravascular interventions: techniques and applications. J Magn Reson Imaging 27:326–338PubMedCrossRefGoogle Scholar
  3. 3.
    Mahnken A, Chalabi K, Jalali F et al (2004) Magnetic resonance-guided placement of aortic stents grafts: feasibility with real-time magnetic resonance fluoroscopy. J Vasc Interv Radiol 15:189–195PubMedGoogle Scholar
  4. 4.
    Omary RA, Frayne R, Unal O et al (2000) MR-guided angioplasty of renal artery stenosis in a pig model: a feasibility study. J Vasc Interv Radiol 11:373–381PubMedCrossRefGoogle Scholar
  5. 5.
    Bucker A, Neuerburg J, Adam G et al (2003) MR-guided coil embolisation of renal arteries in an animal model. Rofo 175:271–274PubMedGoogle Scholar
  6. 6.
    Eggebrecht H, Kuhl H, Kaiser GM et al (2006) Feasibility of real-time magnetic resonance-guided stent-graft placement in a swine model of descending aortic dissection. Eur Heart J 27:613–620PubMedCrossRefGoogle Scholar
  7. 7.
    Nitz WR, Oppelt A, Renz W et al (2001) On the heating of linear conductive structures as guide wires and catheters in interventional MRI. J Magn Reson Imaging 13:105–114PubMedCrossRefGoogle Scholar
  8. 8.
    Omary R, Gehl J, Schirf B et al (2006) MR imaging versus conventional X-ray fluoroscopy-guided renal angioplasty in swine: prospective randomized comparison. Radiology 238:489–496PubMedCrossRefGoogle Scholar
  9. 9.
    Konings MK, Bartels LW, Smits HF et al (2000) Heating around intravascular guidewires by resonating RF waves. J Magn Reson Imaging 12:79–85PubMedCrossRefGoogle Scholar
  10. 10.
    Buecker A, Spuentrup E, Schmitz-Rode T et al (2004) Use of a nonmetallic guide wire for magnetic resonance-guided coronary artery catheterization. Invest Radiol 39:656–660PubMedCrossRefGoogle Scholar
  11. 11.
    Mekle R, Hofmann E, Scheffler K et al (2006) A polymer-based MR-compatible guidewire: a study to explore new prospects for interventional peripheral magnetic resonance angiography (ipMRA). J Magn Reson Imaging 23:145–155PubMedCrossRefGoogle Scholar
  12. 12.
    Kaiser G, Breuckmann F, Aker S et al (2007) Anesthesia for cardiovascular interventions and magnetic resonance imaging in pigs. J Am Assoc Lab Anim Sci 46:30–33PubMedGoogle Scholar
  13. 13.
    Neuerburg J, Bucker A, Adam G et al (1997) Cava filter placement under MRI control. Experimental in vitro and in vivo studies. Rofo 167:418–422PubMedGoogle Scholar
  14. 14.
    Shih MC, Rogers WJ, Hagspiel KD (2006) Real-time magnetic resonance-guided placement of retrievable inferior vena cava filters: comparison with fluoroscopic guidance with use of in vitro and animal models. J Vasc Interv Radiol 17:327–333PubMedCrossRefGoogle Scholar
  15. 15.
    Bucker A, Neuerburg JM, Adam GB et al (2001) Real-time MR guidance for inferior vena cava filter placement in an animal model. J Vasc Interv Radiol 12:753–756PubMedCrossRefGoogle Scholar
  16. 16.
    Glowinski A, Adam G, Bucker A et al (1997) Catheter visualization using locally induced, actively controlled field inhomogeneities. Magn Reson Med 38:253–258PubMedCrossRefGoogle Scholar
  17. 17.
    Dumoulin CL, Souza SP, Darrow RD (1993) Real-time position monitoring of invasive devices using magnetic resonance. Magn Reson Med 29:411–415PubMedCrossRefGoogle Scholar
  18. 18.
    Quick HH, Kuehl H, Kaiser G et al (2003) Interventional MRA using actively visualized catheters, TrueFISP, and real-time image fusion. Magn Reson Med 49:129–137PubMedCrossRefGoogle Scholar
  19. 19.
    Quick HH, Zenge MO, Kuehl H et al (2005) Interventional magnetic resonance angiography with no strings attached: wireless active catheter visualization. Magn Reson Med 53:446–455PubMedCrossRefGoogle Scholar
  20. 20.
    Ocali O, Atalar E (1997) Intravascular magnetic resonance imaging using a loopless catheter antenna. Magn Reson Med 37:112–118PubMedCrossRefGoogle Scholar
  21. 21.
    Rauschenberg J, de Oliveira A, Muller S et al (2007) An algorithm for passive marker localization in interventional MRI. Z Med Phys 17:180–189PubMedGoogle Scholar
  22. 22.
    Shellock FG (2008) Reference manual for magnetic resonance safety, implants and devices: 2008 edition. Biomedical Research Publishing Group, Los Angeles CA, p 422Google Scholar
  23. 23.
    Leiner T, Schoenberg S (2007) Current status of renal artery magnetic resonance imaging: theoretical and practical considerations and the potential role of blood-pool contrast agents. Eur Radiol 17(Suppl. 2):B13–B17PubMedGoogle Scholar
  24. 24.
    Meaney J, Goyen M (2007) Recent advances in contrast-enhanced magnetic resonance angiography. Eur Radiol 17(Suppl 2):B2–B6PubMedGoogle Scholar
  25. 25.
    Bremerich J, Bilecen D, Reimer P (2007) MR angiography with blood pool contrast agents. Eur Radiol 17:3017–3024PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Sebastian Kos
    • 1
  • Rolf Huegli
    • 2
  • Eugen Hofmann
    • 3
  • Harald H. Quick
    • 4
  • Hilmar Kuehl
    • 4
  • Stephanie Aker
    • 5
  • Gernot M. Kaiser
    • 6
  • Paul J. A. Borm
    • 7
  • Augustinus L. Jacob
    • 1
  • Deniz Bilecen
    • 1
  1. 1.Institute of RadiologyUniversity Hospital BaselBaselSwitzerland
  2. 2.Institute of RadiologyKantonsspital BruderholzBruderholzSwitzerland
  3. 3.Vascular InterventionBiotronikBuelachSwitzerland
  4. 4.Department of Diagnostic and Interventional Radiology and NeuroradiologyUniversity of Duisburg-EssenEssenGermany
  5. 5.Institute of PathophysiologyUniversity of Duisburg-EssenEssenGermany
  6. 6.Department of General, Visceral, and Transplantation SurgeryUniversity of Duisburg-EssenEssenGermany
  7. 7.MagnaMedics GmbHAachenGermany

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