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Thursday, August 26, 2004 - 1:30 PM
SES 7A.1

Lead Presentation: MRI Evaluation of In-stent Restenosis: Comparison of CFD, and MR-PVM Measurements

A. Anayiotos, A. Holton, B. Brott, E. Walsh, A. Shih, R. Koomullil, Y. Ito, University of Alabama, Birmingham, AL; R. Venugopalan, Codman, a J&J Company, Raynham, MA

Although drug-eluting stents decrease the incidence of in-stent restenosis, there remains a significant need to non-invasively monitor for restenosis. Magnetic Resonance Imaging (MRI)quantitative flow measurement through stents has been limited due to magnetic susceptibility artifacts and radio frequency shielding effects. Previous in-vitro experiments from our laboratory have shown that NiTi alloy stents exhibit superior MRI compatibility than Stainless Steel Stents. In this study we evaluated the capability of MRI to measure velocity through a 9 mm NiTi stent with different degrees of stenosis. The velocity distributions in three types of in-stent restenoses, two axisymmetric (75% and 90%), and one asymmetric (50%) stenoses were obtained by MR phase contrast Imaging and compared to velocities from computational fluid dynamic (CFD) simulations. Good agreement between the MRI and CFD data was observed for the 50% and 75% stenoses. The agreement was poor for the 90% stenosis and this was most likely due to the high velocity gradients found in the small luminal area and the low pixel resolution in MR imaging settings. The accuracy of the MRI velocities inside the stented area renders MRI as a modality that may be used in the assessment of in-stent restenosis in moderate size vascular stents in peripheral vessels such as the iliac, carotid or femoral arteries. With advances in magnetic resonance instrumentation, the resolution of MRI may be able to provide adequate velocity information in smaller vessels, such as the coronaries and substitute dangerous and expensive catheterization procedures that are currently in clinical use.