Endovascular MRA and Intervention

Numerous studies have been performed recently to explore the feasibility of performing endovas-cular procedures in an endovascular environment. These studies have ranged from performing basic diagnostic studies such as direct intra-arterial enhanced MRA to performing complex interventions such as iliac and renal stenting to even endovascu-lar aneurysm repair under MR guidance [19-23]. This exciting technology will undoubtedly change the way in which endovascular interventions are performed. The prospect of being able to perform endovascular procedures without exposure to ionizing radiation and the use of nephrotoxic contrast agents is quite appealing. This technology may

Fig. 9a-d. MRA (a) demonstrating Leriche syndrome (occlusion of the distal abdominal aorta and bilateral common iliac arteries). b Corresponding DSA. The patient had bilateral nitinol stents placed in the iliac arteries (c). The follow up MRA (d) shows mild artifact over the iliac stents (arrows)
Right Iliac Aneurysm
Fig. 10a-c. Right renal artery aneurysm which underwent embolization with platinum coils. Follow up MRA shows no perfusion to the aneurysm. There is little or no artifact from the coils

offer a larger population of patients the possibility of endovascular surgery.

The imaging requirements for endovascular procedure are much more complex than those previously required for open vascular procedures. The technological advances in imaging have kept up so far with the advances related to the procedures. At present fine detail is required for all endovascular candidates in order to choose the proper patients and to optimize the outcome. The result of poor planning is usually technical failure with the need for repeat procedures or ultimately conversion to an open surgery. As a result post procedure imaging is essential to monitor the success of the procedure and to plan any further interventions. The en-dovascular specialist must be well versed with the latest imaging technology in order to guarantee technical success and to adequately follow patients who have undergone these minimally invasive procedures.

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Essentials of Human Physiology

Essentials of Human Physiology

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