Trisha Roy1,2, Garry Liu1, Noor Shaikh1, Kevan Anderson1, Nicolas Yak1, Xiuling Qi1, Andrew Dueck1,2, and Graham Wright1,3
1Schulich Heart Program and the Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, 2Division of Vascular Surgery, University of Toronto, Toronto, Canada, 3Department of Medical Biophysics, University of Toronto, Toronto, Canada
Percutaneous vascular
interventions (PVI) for treating peripheral arterial disease (PAD) have poor
outcomes with high re-intervention and failure rates. Not all lesions are
amenable to PVI, but predicting failure is difficult. While CT can identify
heavily calcified lesions, current imaging offers limited differentiation
between hard and soft PAD plaques, which impacts procedural success. This study
demonstrates the feasibility of using MRI biomarkers to characterize plaque
components in ex-vivo human peripheral arteries with histologic and microCT
validation. We demonstrate that significantly higher puncture forces are
required to cross non-calcified “hard” chronic total occlusions (CTOs) compared
to “soft” CTOs, as classified by these MRI biomarkers.