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，我们继续使用快速MRI来指导简单而复杂的机械和生物学干预措施。 我们正在开发临床级导管设备，以重新恢复周围动脉的慢性总闭塞。 这些应该准备明年进行临床测试。 其他导管设备也正在开发动物的实时MRI程序。 我们正在开发基于导管的二尖瓣环形成形术，以治疗功能性二尖瓣反流。 我们在二尖瓣反流的猪模型中取得了初步成功。 我们开发了在基于临床前和临床导管程序中，将现有感兴趣的MRI衍生区域与实时X射线相结合或融合的方法。 例如，我们与MRI（XFM）系统融合的X射线促进了对X射线fluroscopicy下的心肌目标的精确注射。 我们计划进一步开发这些技术，以促进广泛的部署。 临床研究即将开始使用实时MRI全面进行人类外周动脉干预，并使用实时MRI完全使用人类主动脉缩写。在人类基因转移实验中，使用新的转录上调剂进行治疗性血管生成的临床注册持续。该试验将测试安全性以及疗效的MRI评估。