Kos Sebastian, Huegli Rolf, Hofmann Eugen, Quick Harald H, Kuehl Hilmar, Aker Stephanie, Kaiser Gernot M, Borm Paul J, Jacob Augustinus L, Bilecen Deniz
Division of Interventional Radiology, Institute of Radiology, University Hospital Basel, Basel, Switzerland.
Invest Radiol. 2009 Apr;44(4):234-41. doi: 10.1097/RLI.0b013e31819b00f1.
Demonstrate the usability of a new polyetheretherketone (PEEK)-based MR-compatible guidewire for renal artery catheterization, angioplasty, and stenting under MR-guidance using MR-visible markers, in vitro and in vivo.
The new 0.035'' guidewire with fiber-reinforced PEEK core, a soft tip, and a hydrophilic coating was used. Paramagnetic markings were coated on the wire and nonbraided catheters for passive visualization. Bending stiffness of the guidewire was compared with available hydrophilic guidewires (Terumo Glidewire Stiff and Standard). A human aortic silicon phantom and 2 pigs were used. The study was animal care and use approved by the committee. Under MR-guidance, renal arteries were catheterized, balloon angioplasty was performed, and balloon expandable renal artery stents were deployed in vivo. Post mortem autopsy was performed. Guidewire visibility, pushability, steerability, and device-support capabilities of the marked guidewire were qualitatively assessed. Procedure times were recorded.
Bending stiffness of the new PEEK-based wire was comparable with Standard Glidewire. In vitro and in vivo guidewire guidance, catheter configuration, renal artery catheterization, and balloon angioplasty were successful. In pigs, stent deployments were successful in both renal arteries. Autopsy revealed acceptable stent positioning. Guidewire visibility through applied markers was acceptable. Steerability, pushability, and device support were good in vitro and in vivo.
The PEEK-based guide allows percutaneous MR-guided renal artery angioplasty and stenting with sufficient visibility, good steerability, pushability, and device support.
在体外和体内展示一种新型的基于聚醚醚酮（PEEK）的磁共振兼容导丝在磁共振引导下用于肾动脉插管、血管成形术和支架置入术的可用性，该导丝使用了磁共振可见标记。
使用了新型的0.035英寸导丝，其具有纤维增强的PEEK芯、柔软尖端和亲水涂层。顺磁性标记物被涂覆在导丝和非编织导管上以实现被动可视化。将该导丝的弯曲刚度与现有的亲水导丝（泰尔茂滑导丝硬型和标准型）进行比较。使用了一个人体主动脉硅树脂模型和2头猪。该研究获得了动物护理和使用委员会的批准。在磁共振引导下，在体内进行肾动脉插管、球囊血管成形术以及植入球囊扩张式肾动脉支架。进行了死后尸检。对标记导丝的可视性、推送性、可操控性和器械支撑能力进行了定性评估。记录了手术时间。
新型基于PEEK的导丝的弯曲刚度与标准滑导丝相当。体外和体内的导丝引导、导管构型、肾动脉插管和球囊血管成形术均成功。在猪体内，双侧肾动脉的支架置入均成功。尸检显示支架定位可接受。通过应用标记物的导丝可视性可接受。体外和体内的可操控性、推送性和器械支撑良好。
基于PEEK的导丝能够在经皮磁共振引导下进行肾动脉血管成形术和支架置入术，具有足够的可视性、良好的可操控性、推送性和器械支撑。
