Grant: Project Grant

Occlusive peripheral arterial disease occurs when blockages in blood vessels limit the blood supply to the leg. This disease is widespread and represents a major societal burden. Approximately 20% of those over the age of 59 years suffer from this disease, which results in over 160,000 limb amputations being performed per year in the US alone. Our goal over the next 5 years is to extend the role of magnetic resonance imaging (MRI) to increase the success rates in patients who can have this disease treated using minimally invasive percutaneous techniques using catheters and wires advanced through blood vessels. X-ray fluoroscopy, the imaging modality that is currently used to guide percutaneous procedures, has relatively poor soft tissue contrast. This makes it difficult to visualize blockages and to ensure that a revascularization device stays within the vessel during the procedure. This limits success rates and restricts minimally invasive treatment to short blockages in large arteries (which occur much less frequently than long occlusions further down the leg). Other treatment options include bypass surgery, which has substantial associated risk, and medical therapy, which has been shown to have limited effectiveness. MRI, unlike x-ray, has excellent soft-tissue contrast and with MRI it is possible to develop a detailed picture of blocked vessels and downstream tissue that can greatly aid in guiding revascularization procedures. Through a program of technical developments we plan to advance methods which will improve revascularization of blocked blood vessels. We anticipate this will facilitate less invasive treatment in a significant population that would ordinarily be subjected to more invasive surgery or to less effective treatments.