Biological and mechanical therapies enabled by cardiovascular interventional MRI

心血管介入 MRI 实现生物和机械治疗

• 批准号: 7594421
• 负责人: Robert J Lederman
• 金额: $ 315.56万
• 依托单位: NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7594421
• 关键词: Anatomy; Animals; Aortic coarctation; Arteries; Arteriographies; Biological; Biopsy; Bypass; Cardiovascular system; Catheters; Cells; Chronic; Clinical; Clinical Research; Complex; Coronary; Development; Devices; Enrollment; Family suidae; Gene Transfer; Heart Atrium; Human; Injection of therapeutic agent; Intervention; Invasive; Magnetic Resonance Imaging; Mechanics; Methods; Mitral Valve; Mitral Valve Insufficiency; Modeling; Myocardial; Peripheral; Procedures; Puncture procedure; Roentgen Rays; Safety; System; Testing; Time; Work; base; human subject; interest; novel; pre-clinical; research clinical testing; research study; success; technology development; therapeutic angiogenesis

During the past year we have continued our work applying rapid MRI to guide simple and complex mechanical and biological interventions. We are developing clinical-grade catheter devices to recanalize chronic total occlusions of peripheral arteries. These should be ready for clinical testing next year. Other catheter devices also are under development for real-time MRI procedures in animals. We are developing catheter-based mitral annuloplasty to treat functional mitral valve regurgitation. We have had preliminary success in porcine models of mitral valve regurgitation. We have developed methods to combine or fuse prior MRI-derived regions of interest with real-time X-ray during preclinical and clinical catheter-based procedures. For example, our X-ray Fused with MRI (XFM) system facilitated precise injections to myocardial targets under X-ray fluroscopy. We plan further development of these technologies to facilitate widespread deployment. Clinical studies are about to begin conducting human peripheral artery intervention wholly using real-time MRI, and stenting of aortic coarctation in humans wholly using real-time MRI. Clinical enrollment continues in a human gene transfer experiment for therapeutic angiogenesis using a novel transcriptional upregulator; the trial will test safety as well as MRI assessment of efficacy.

在过去的一年中，我们继续应用快速MRI指导简单和复杂的机械和生物干预。 我们正在开发临床级导管装置，用于再通慢性完全闭塞的外周动脉。 这些应该可以在明年进行临床试验。 其他导管装置也正在开发中，用于动物的实时MRI程序。 我们正在开发基于导管的二尖瓣环成形术，以治疗功能性二尖瓣返流。 我们已经在猪二尖瓣反流模型中取得了初步成功。 我们已经开发了在临床前和临床导管手术期间将先前MRI衍生的感兴趣区域与实时X射线联合收割机或融合的方法。 例如，我们的X射线融合MRI（XFM）系统有助于在X射线荧光镜下对心肌靶点进行精确注射。 我们计划进一步开发这些技术，以促进广泛部署。 临床研究即将开始，完全使用实时MRI进行人体外周动脉介入，以及完全使用实时MRI进行人体主动脉缩窄支架植入术。临床招募继续在人类基因转移实验治疗血管生成使用一种新的转录上调;试验将测试安全性以及MRI评估的疗效。