Interventional procedures gain increasing importance in medical areas such as primarily radiological, cardiovascular, neurological, interventional tumor therapy or pediatric radiology and cardiology as they are less invasive and thereby reduce the burden to the patient. The healthcare system benefits from more precise and quicker treatments with less complications and reduced costs. Visualization of the interventional medical devices is achieved by X-ray, MRI and ultrasound imaging. Most of the procedures today are carried out under X-ray imaging, i.e. fluoroscopy and computer tomography (CT).
MRI is a well established method in the diagnostic spectrum of medical procedures and gains more and more importance in the interventional medicine. Interstitial procedures - which do not require MR safe guidewires - are already routinely established e.g. for breast and prostate biopsies. Efficient interventional MRI has become possible in recent years with the availability of high speed computers allowing real-time imaging, and of powerful wide bore 1.5T and 3T MR scanners delivering high resolution images and enabling operational handling of the patient by the physician.
The benefits of MRI over X-ray imaging are:
- continuously „see where you are“ compared to X-ray fluoroscopy where blood vessels can be visualized only indirectly by application of iodine contrast agents, and only for short imaging "shots" only
- radiation-free high soft tissue contrast which otherwise can only be achieved by CT with high radiation doses
- in addition to morphological data, functional and metabolic data can be gathered (vitality, perfusion, flux).
As most of the medical devices are applied in soft tissue for diagnosis or therapy there is a huge opportunity for improvement of current interventional medical procedures guided by X-ray imaging.
Conventional medical devices usually are not appropriate for MRI-guided interventions due to electric conductivity of longer metal parts contained therein and lack of acceptable visibility without deterioration of tisssue imaging. Appropriately designed MR safe guidewires are a prerequisite to fulfill good clinical practice in endovascular interventions and to advance catheters to their target organ or blood vessel.
Upon commercial availability of the MR safe MaRVis Guidewires a broad spectrum of diagnostic and therapeutic applications is envisageable such as e.g.:
- stroke treatment
- cardiologic interventions (e.g. ablation, hemodynamic measurements, heart valve replacement, etc.)
- detection and treatment of lesions in blood vessels (angiography, angioplasty)
- aortic and venous stenting
- interventional oncology (e.g. chemotherapy, tumor ablation, brachytherapy, etc.)
- treatment of sensitive patients (e.g. renal insufficiency => contrast agent intolerance)
- pediatric cardiologic and radiologic procedures
- any complex and lengthy intervention further favours application of radiation-free imaging techniques.
Recent scientific publications have demonstrated that generally MRI-guided interventions are feasible with specifically designed guidewires. Yet, material properties and MRI visibility of those guidewires have turned out to be insufficient. Guidewires derived from the MaRVis platform technology overcome these shortfalls.