Percutaneous MR Guided Creation of a Meso-Caval Shunt

Summary

Principal Investigator: Aravind Arepally
Abstract: DESCRIPTION (provided by candidate): The Mentored Clinical Scientist Development Award will support the program outlined in this proposal, a program that will enable the Principal Investigator, an Interventional Radiologist, to combine his clinical skills and training with interventional magnetic resonance imaging (MRI) research and become an independent clinical scientist in the field of interventional MR (iMR). Research will be focused on the development of an innovative, minimally invasive mesocaval shunt that will not only provide safe and accurate implementation of the new shunt, but also serve as a vehicle for delivery of therapeutics to the liver, spleen, and pancreas. The candidate's immediate goal is to gain expertise and knowledge of Magnetic Resonance Imaging techniques as they relate to vascular imaging, as well as research methodology. The candidate's long-term goal is to become an independent biomedical researcher who is focused on translational research in iMR. To achieve these goals, the candidate and his mentor, Ergin Atalar, Ph.D., have developed a career development plan that includes: a) protected research time (75 percent); b) didactic coursework on MR vascular imaging and research techniques; and c) an advisory panel of established multidisciplinary investigators, with expertise in several fields related to this proposal. As a clinician trained in interventional procedures, the candidate has had experience with the interventions required as a result of complications from cirrhosis of the liver. Due to the development of portal hypertension, decompression of the portal venous system has traditionally been accomplished with either a surgical shunt or a percutaneous transjugular intrahepatic portosystemic shunt (TIPS). In addition, minimally invasive access to the spleno-meso-portal venous system creates the opportunity for the development of novel therapies for diseases of the pancreas, liver, and spleen. Using only real-time MR guidance, the candidate will work closely with his assembled team to create a minimally invasive meso-caval shunt The following specific aims will support these goals: (1) Develop a novel intravascular needle system to perform MR-guided vena cava punctures; (2) Develop and implement an MRI protocol that will provide complete real-time 3D anatomical definition of devices and target vessels in order to safely perform MR-guided interventions; (3) Demonstrate that a ,meso-caval shunt can be constructed and implemented safely under MR guidance using a novel anastomotic device; and (4) Determine that injection therapies can be delivered accurately to the pancreas, liver, and spleen under MR guidance. The Department of Radiology, with its long history of groundbreaking achievements in Radiology research, will provide a supportive and nurturing environment in which the Principal Investigator can establish a future as an independent clinical scientist.
Funding Period: 2005-04-01 - 2008-10-31
more information: NIH RePORT

Top Publications

  1. ncbi Radiopaque alginate microcapsules for X-ray visualization and immunoprotection of cellular therapeutics
    B P Barnett
    Russell H Morgan Department of Radiology and Radiological Science and Institute for Cell Engineering, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
    Mol Pharm 3:531-8. 2006
  2. pmc Synthesis of magnetic resonance-, X-ray- and ultrasound-visible alginate microcapsules for immunoisolation and noninvasive imaging of cellular therapeutics
    Brad P Barnett
    Russell H Morgan Department of Radiology, Division of Magnetic Resonance Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    Nat Protoc 6:1142-51. 2011
  3. pmc Fluorocapsules for improved function, immunoprotection, and visualization of cellular therapeutics with MR, US, and CT imaging
    Brad P Barnett
    Russell H Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, 720 Rutland Ave, 217 Traylor, Baltimore, MD 21205, USA
    Radiology 258:182-91. 2011
  4. pmc MR-guided portal vein delivery and monitoring of magnetocapsules: assessment of physiologic effects on the liver
    Thomas W Link
    Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    J Vasc Interv Radiol 22:1335-40. 2011
  5. pmc Catheter-directed gastric artery chemical embolization suppresses systemic ghrelin levels in porcine model
    Aravind Arepally
    Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, 600 N Wolfe St, Blalock 544, Baltimore, MD 21287, USA
    Radiology 249:127-33. 2008
  6. ncbi Tracking planar orientations of active MRI needles
    Shashank Sathyanarayana
    Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, Maryland, USA
    J Magn Reson Imaging 26:386-91. 2007
  7. ncbi Magnetic resonance-guided, real-time targeted delivery and imaging of magnetocapsules immunoprotecting pancreatic islet cells
    Brad P Barnett
    Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutes, Blalock 644, 600 North Wolfe Street, Baltimore, Maryland 21212, USA
    Nat Med 13:986-91. 2007
  8. ncbi Catheter-directed gastric artery chemical embolization for modulation of systemic ghrelin levels in a porcine model: initial experience
    Aravind Arepally
    Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutes, Johns Hopkins Hospital, Blalock 545, 600 N Wolfe St, Baltimore, MD 21287, USA
    Radiology 244:138-43. 2007
  9. ncbi Evaluation of MR/fluoroscopy-guided portosystemic shunt creation in a swine model
    Aravind Arepally
    Russell H Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Blalock 545, 600 North Wolfe Street, Baltimore, MD 21287, USA
    J Vasc Interv Radiol 17:1165-73. 2006
  10. pmc X-ray-visible microcapsules containing mesenchymal stem cells improve hind limb perfusion in a rabbit model of peripheral arterial disease
    Dorota A Kedziorek
    Russell H Morgan Department of Radiology and Radiological Science, Division of MR Research, Institute for Cell Engineering, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
    Stem Cells 30:1286-96. 2012

Detail Information

Publications10

  1. ncbi Radiopaque alginate microcapsules for X-ray visualization and immunoprotection of cellular therapeutics
    B P Barnett
    Russell H Morgan Department of Radiology and Radiological Science and Institute for Cell Engineering, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
    Mol Pharm 3:531-8. 2006
    ..While human cadaveric islets were used as a proof-of-principle, these radiopaque capsules may have wide ranging therapeutic applications for a variety of cell types...
  2. pmc Synthesis of magnetic resonance-, X-ray- and ultrasound-visible alginate microcapsules for immunoisolation and noninvasive imaging of cellular therapeutics
    Brad P Barnett
    Russell H Morgan Department of Radiology, Division of Magnetic Resonance Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    Nat Protoc 6:1142-51. 2011
    ..The entire synthesis can be completed within 2 h...
  3. pmc Fluorocapsules for improved function, immunoprotection, and visualization of cellular therapeutics with MR, US, and CT imaging
    Brad P Barnett
    Russell H Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, 720 Rutland Ave, 217 Traylor, Baltimore, MD 21205, USA
    Radiology 258:182-91. 2011
    ..To develop novel immunoprotective alginate microcapsule formulations containing perfluorocarbons (PFCs) that may increase cell function, provide immunoprotection for xenografted cells, and simultaneously enable multimodality imaging...
  4. pmc MR-guided portal vein delivery and monitoring of magnetocapsules: assessment of physiologic effects on the liver
    Thomas W Link
    Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
    J Vasc Interv Radiol 22:1335-40. 2011
    ..This study was designed to assess the physiologic effects of the delivery of a clinical dose of MCs (140,000 capsules) into the portal vein (PV) in swine over a 1-month period...
  5. pmc Catheter-directed gastric artery chemical embolization suppresses systemic ghrelin levels in porcine model
    Aravind Arepally
    Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, 600 N Wolfe St, Blalock 544, Baltimore, MD 21287, USA
    Radiology 249:127-33. 2008
    ..To prospectively test, in a porcine model, the hypothesis that catheter-directed gastric artery chemical embolization (GACE) can result in suppression of systemic ghrelin levels and affect weight gain...
  6. ncbi Tracking planar orientations of active MRI needles
    Shashank Sathyanarayana
    Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, Maryland, USA
    J Magn Reson Imaging 26:386-91. 2007
    ..To determine and track the planar orientation of active interventional devices without using localizing RF microcoils...
  7. ncbi Magnetic resonance-guided, real-time targeted delivery and imaging of magnetocapsules immunoprotecting pancreatic islet cells
    Brad P Barnett
    Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutes, Blalock 644, 600 North Wolfe Street, Baltimore, Maryland 21212, USA
    Nat Med 13:986-91. 2007
    ..These findings are directly applicable to ongoing improvements in islet cell transplantation for human diabetes, particularly because our magnetocapsules comprise clinically applicable materials...
  8. ncbi Catheter-directed gastric artery chemical embolization for modulation of systemic ghrelin levels in a porcine model: initial experience
    Aravind Arepally
    Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutes, Johns Hopkins Hospital, Blalock 545, 600 N Wolfe St, Baltimore, MD 21287, USA
    Radiology 244:138-43. 2007
    ..To prospectively test, in a porcine model, the hypothesis that use of catheter-directed gastric artery chemical embolization (GACE) can result in substantial suppression of systemic ghrelin levels...
  9. ncbi Evaluation of MR/fluoroscopy-guided portosystemic shunt creation in a swine model
    Aravind Arepally
    Russell H Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Blalock 545, 600 North Wolfe Street, Baltimore, MD 21287, USA
    J Vasc Interv Radiol 17:1165-73. 2006
    ..To evaluate three different percutaneous portosystemic shunts created with magnetic resonance (MR) imaging and fluoroscopy guidance in a swine model...
  10. pmc X-ray-visible microcapsules containing mesenchymal stem cells improve hind limb perfusion in a rabbit model of peripheral arterial disease
    Dorota A Kedziorek
    Russell H Morgan Department of Radiology and Radiological Science, Division of MR Research, Institute for Cell Engineering, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
    Stem Cells 30:1286-96. 2012
    ..MSC-Xcaps represent the first x-ray-visible cellular therapeutic with enhanced efficacy for PAD treatment...