Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

Peripheral arterial disease (PAD) is a morbid, mortal and prevalent condition that affects over 800,000 Canadians. It is one of the most common cardiovascular diseases. Lack of blood flow to the leg causes exertional pain and is associated with poor quality of life and disability. When PAD is severe it is called "critical limb ischemia". In this subset of patients, major amputation is required within 1 year in up to 40% of patients. Vascular disease in the legs is often indicative of vascular disease in the heart and other areas of the body. This is why up to 20% of these patients die within 6 months from cardiovascular complications. Current treatment options for PAD involve re-establishing blood flow to the leg through either bypass surgery or percutaneous vascular intervention (PVI). PVI is a less invasive approach with improved morbidity and shorter length of hospital stay compared to surgery. PVI is currently guided with x-ray fluoroscopy, which offers very limited visualization of the diseased arteries in the leg. Due to these challenges, PVI has high immediate technical failure rates (20%) and high re-intervention rates (30%). This is why PVI is currently only recommended for a small proportion of PAD patients, indicating a large under-served population that go on to have morbid bypass surgeries or require amputations. MRI is capable of producing high quality images of the blood flow in the legs. In our study, we will develop and validate MRI methods of visualizing diseased arteries in the leg to facilitate PVI. MRI can significantly advance the treatment of PAD to treat more patients in a minimally invasive way, with the potential of improving amputation rates, disability outcomes and quality of life in this growing patient population.