{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:00:57Z","timestamp":1792807257073,"version":"4.5.0"},"reference-count":50,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2016,9,25]],"date-time":"2016-09-25T00:00:00Z","timestamp":1474761600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:p>\n                    Purpose: To test and validate magnetic resonance imaging (MRI) sequences for peripheral artery lesion characterization and relate the MRI characteristics to the amount of force required for a guidewire to puncture peripheral chronic total occlusions (CTOs) as a surrogate for immediate failure of endovascular therapy. Methods: Diseased superficial femoral, popliteal, and tibial artery segments containing 55 atherosclerotic lesions were excised from the amputated limbs of 7 patients with critical limb ischemia. The lesions were imaged at high resolution (75 \u03bcm\n                    <jats:sup>3<\/jats:sup>\n                    voxels) with T2-weighted (T2W) and ultrashort echo time (UTE) sequences on a 7-T MR scanner. The MR images (n=15) were validated with micro\u2013computed tomography and histology. CTOs (n=40) were classified by their MR signal characteristics as \u201csoft\u201d (signals indicating fat, thrombus, microchannels, or loose fibrous tissue), \u201chard\u201d (collagen and\/or speckled calcium signals), or \u201ccalcified\u201d (calcified nodule signals). A 2-kg load cell advanced the back end of a 0.035-inch stiff guidewire at a fixed displacement rate (0.05 mm\/s) through the CTOs, and the forces required to cross each lesion were measured. Results: T2W images showed fat as hyperintense and hardened tissue as hypointense. Calcium and thrombus appeared as a signal void in conventional MRI sequences but were easily identified in UTE images (thrombus was hyperintense and calcium hypointense). MRI accurately differentiated \u201chard,\u201d \u201csoft,\u201d and \u201ccalcified\u201d CTOs based on associated guidewire puncture force. The guidewire could not enter \u201ccalcified\u201d CTOs (n=6) at all. \u201cHard\u201d CTOs (n=9) required a significantly higher (p&lt;0.001) puncture force of 1.71\u00b10.51 N vs 0.43\u00b10.36 N for \u201csoft\u201d CTOs (n=25). Conclusion: MRI characteristics of PAD lesions correlate with guidewire puncture forces, an important aspect of crossability. Future work will determine if clinical MR scanners can be used to predict success in peripheral vascular interventions.\n                  <\/jats:p>","DOI":"10.1177\/1526602816671135","type":"journal-article","created":{"date-parts":[[2016,9,22]],"date-time":"2016-09-22T21:19:22Z","timestamp":1474579162000},"page":"35-46","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":29,"title":["Puncturing Plaques"],"prefix":"10.1177","volume":"24","author":[{"given":"Trisha","family":"Roy","sequence":"first","affiliation":[{"name":"Schulich Heart Program and the Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"},{"name":"Division of Vascular Surgery, Department of Surgery, University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garry","family":"Liu","sequence":"additional","affiliation":[{"name":"Schulich Heart Program and the Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"},{"name":"Department of Medical Biophysics, University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor","family":"Shaikh","sequence":"additional","affiliation":[{"name":"Division of Engineering Science, University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew D.","family":"Dueck","sequence":"additional","affiliation":[{"name":"Schulich Heart Program and the Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"},{"name":"Division of Vascular Surgery, Department of Surgery, University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham A.","family":"Wright","sequence":"additional","affiliation":[{"name":"Schulich Heart Program and the Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, 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