Evaluation of Vascular Pathology With 3D, Time-Resolved Phase Contrast Magnetic Resonance Imaging (MRI)

NCT00722904 | Completed DMC

• 2 other identifiers: H627-30777H627-30777-01A
• Study Type: observational
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Aortic coarctation is a relatively common cardiovascular condition with high associated mortality if not treated. Even with successful repair, however, close follow up is needed as late complications can result in significant cardiovascular morbidity. MRI, with is ability to provide both anatomic and hemodynamic information, is becoming the imaging option of choice for post-intervention surveillance. Time-resolved, three-dimensional phase contrast magnetic resonance velocity (4D Flow) profiling enables the acquisition of multidirectional blood velocity data. The technique is well suited for evaluation of blood flow patterns in the thoracic aorta. By comparing aortic flow patterns in patients status post coarctation repair with those of healthy volunteers using 4D Flow, this study intends to characterize abnormal flow patterns in these patients with the eventual goal of better understanding and predicting late complications so that preemptive intervention may be taken. Given the potential use of 4D Flow for evaluation of other types of vascular pathology in the aorta and other vascular regions, we hope to investigate the use of the technique on a limited basis for a broader population of adult patients. Other research groups have had success evaluating peripheral stenoses, as well as intracardiac and intracranial blood flow patterns with 4D Flow.

Conditions

Healthy

Keywords

post-intervention surveillance of aortic coarctation; MRA and 2D phase contrast imaging; 4D Flow velocity mapping; Patients undergoing routine post-intervention surveillance of aortic coarctation; Healthy volunteers

Outcome Measures

Primary Outcomes (1)

• predicting late complications in patients status post coarctation repair so that preemptive intervention may be taken

  For at least three years following the completion of the study, the database of patients will be updated for clinically relevant information

Study Arms (2)

1

patients undergoing routine post-intervention surveillance of aortic coarctation

2

Healthy volunteers

Eligibility Criteria

• Age: 1 Year+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients: primarily status post intervention for repair of aortic coarctation and undergoing routine MRI follow up, but also adult patients with other vascular pathologies undergoing routine MRI evaluation, who may be good candidates for 4D Flow blood flow analysis. Healthy subjects: healthy members of the radiology residency program and staff at UCSF.

You may qualify if:

• Patients: primarily status post intervention for repair of aortic coarctation and undergoing routine MRI follow up, but also adult patients with other vascular pathologies undergoing routine MRI evaluation, who may be good candidates for 4D Flow blood flow analysis.
• Healthy subjects: healthy members of the radiology residency program and staff at UCSF.

You may not qualify if:

• Anyone else.

Sponsors & Collaborators

• University of California, San Francisco: lead

Study Sites (1)

UCSF Medical Center

San Francisco, California, 94143, United States

Location

Related Publications (15)

• Markl M, Draney MT, Hope MD, Levin JM, Chan FP, Alley MT, Pelc NJ, Herfkens RJ. Time-resolved 3-dimensional velocity mapping in the thoracic aorta: visualization of 3-directional blood flow patterns in healthy volunteers and patients. J Comput Assist Tomogr. 2004 Jul-Aug;28(4):459-68. doi: 10.1097/00004728-200407000-00005.

  PMID: 15232376 BACKGROUND

• Hope MD, Levin JM, Markl M, Draney MT, Alley M, Herfkens RJ. Images in cardiovascular medicine. Four-dimensional magnetic resonance velocity mapping in a healthy volunteer with pseudocoarctation of the thoracic aorta. Circulation. 2004 Jun 29;109(25):3221-2. doi: 10.1161/01.CIR.0000134277.42512.D5. No abstract available.

  PMID: 15226232 BACKGROUND

• Hope MD, Levin JM, Markl M, Draney MT, Wilson N, Herfkens RJ. 4D Magnetic Resonance Velocity Mapping: Velocity Profile of Blood-Flow Through the Thoracic Aorta in 10 Healthy Volunteers. Abstract. ISMRM 12th Scientific Meeting, 2004

  BACKGROUND

• Hope MD, Levin JM, Markl M, Draney MT, Alley MT, Dunn WN, Pelc NJ, Herfkens RJ. Four-Dimensional Magnetic Resonance Velocity Mapping: Velocity Profile of Blood Flow Through the Thoracic Aorta in 10 Healthy Volunteers. Lauterbur Award. Young Investigator Research Abstract Awards, SCBT/MR, 2004.

  BACKGROUND

• Shih MC, Tholpady A, Kramer CM, Sydnor MK, Hagspiel KD. Surgical and endovascular repair of aortic coarctation: normal findings and appearance of complications on CT angiography and MR angiography. AJR Am J Roentgenol. 2006 Sep;187(3):W302-12. doi: 10.2214/AJR.05.0424.

  PMID: 16928909 BACKGROUND

• Celermajer DS, Greaves K. Survivors of coarctation repair: fixed but not cured. Heart. 2002 Aug;88(2):113-4. doi: 10.1136/heart.88.2.113.

  PMID: 12117824 BACKGROUND

• Toro-Salazar OH, Steinberger J, Thomas W, Rocchini AP, Carpenter B, Moller JH. Long-term follow-up of patients after coarctation of the aorta repair. Am J Cardiol. 2002 Mar 1;89(5):541-7. doi: 10.1016/s0002-9149(01)02293-7.

  PMID: 11867038 BACKGROUND

• Klipstein RH, Firmin DN, Underwood SR, Rees RS, Longmore DB. Blood flow patterns in the human aorta studied by magnetic resonance. Br Heart J. 1987 Oct;58(4):316-23. doi: 10.1136/hrt.58.4.316.

  PMID: 3676019 BACKGROUND

• Bogren HG, Klipstein RH, Firmin DN, Mohiaddin RH, Underwood SR, Rees RS, Longmore DB. Quantitation of antegrade and retrograde blood flow in the human aorta by magnetic resonance velocity mapping. Am Heart J. 1989 Jun;117(6):1214-22. doi: 10.1016/0002-8703(89)90399-2.

  PMID: 2729051 BACKGROUND

• Kilner PJ, Yang GZ, Mohiaddin RH, Firmin DN, Longmore DB. Helical and retrograde secondary flow patterns in the aortic arch studied by three-directional magnetic resonance velocity mapping. Circulation. 1993 Nov;88(5 Pt 1):2235-47. doi: 10.1161/01.cir.88.5.2235.

  PMID: 8222118 BACKGROUND

• Hope TA, Markl M, Wigstrom L, Alley MT, Miller DC, Herfkens RJ. Comparison of flow patterns in ascending aortic aneurysms and volunteers using four-dimensional magnetic resonance velocity mapping. J Magn Reson Imaging. 2007 Dec;26(6):1471-9. doi: 10.1002/jmri.21082.

  PMID: 17968892 BACKGROUND

• Saeed M, Henk CB, Weber O, Martin A, Wilson M, Shunk K, Saloner D, Higgins CB. Delivery and assessment of endovascular stents to repair aortic coarctation using MR and X-ray imaging. J Magn Reson Imaging. 2006 Aug;24(2):371-8. doi: 10.1002/jmri.20631.

  PMID: 16786568 BACKGROUND

• Pujadas S, Reddy GP, Weber O, Tan C, Moore P, Higgins CB. Phase contrast MR imaging to measure changes in collateral blood flow after stenting of recurrent aortic coarctation: initial experience. J Magn Reson Imaging. 2006 Jul;24(1):72-6. doi: 10.1002/jmri.20613.

  PMID: 16755530 BACKGROUND

• Frydrychowicz A, Winterer JT, Zaitsev M, Jung B, Hennig J, Langer M, Markl M. Visualization of iliac and proximal femoral artery hemodynamics using time-resolved 3D phase contrast MRI at 3T. jMRI 2007 vol. 25 pp. 1085-92. 15. Bammer R, Hope TA, Aksoy M, Alley MT. Time-resolved 3D quantitative flow MRI of the major intracranial vessels: initial experience and comparative evaluation at 1.5T and 3.0T in combination with parallel imaging. MRM 2007: 57:127-40.

  BACKGROUND

• Wigstrom L, Ebbers T, Fyrenius A, Karlsson M, Engvall J, Wranne B, Bolger AF. Particle trace visualization of intracardiac flow using time-resolved 3D phase contrast MRI. Magn Reson Med. 1999 Apr;41(4):793-9. doi: 10.1002/(sici)1522-2594(199904)41:43.0.co;2-2.

  PMID: 10332856 BACKGROUND

Study Officials

• Charles B Higgins, MD

  UCSF Department of Radiology

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 24, 2008
• First Posted: July 28, 2008
• Study Start: June 1, 2007
• Primary Completion: July 1, 2009
• Study Completion: September 1, 2010
• Last Updated: October 8, 2013

Record last verified: 2013-10

Locations

US (1)