Courtesy of Prof Giles Roditi, Dr Pauline Hall Barrientos and Dr Sokratis Stoumpos, this image shows dynamic time-resolved magnetic resonance angiography (MRA) in a coronal section of the arm for which ferumoxytol, an iron oxide nanoparticle, was used as the contrast agent. This animated image demonstrates ferumoxytol-enhanced MRA for vascular mapping prior to arteriovenous fistula (AVF) creation for haemodialysis in patients with chronic kidney disease. Simultaneous arterial and venous enhancement, notably, is enabled by the prolonged intravascular half-life of ferumoxytol. Additionally, ferumoxytol can be safely used as a contrast agent in patients with renal failure for whom conventional gadolinium-enhanced MRA or CT angiography with iodinated contrast material carry potential risks of toxicity.
In a recently published study of patients with chronic kidney disease undergoing peripheral vascular mapping before haemodialysis access creation, ferumoxytol-enhanced MRA better predicted successful AVF outcome compared with duplex ultrasound and also outperformed duplex ultrasound in accurate visualisation of the central vasculature:
Stoumpos S, Tan A, Hall Barrientos P, Stevenson K, Thomson PC, Kasthuri R, Radjenovic A, Kingsmore DB, Roditi G, Mark PB. Ferumoxytol MR Angiography versus Duplex US for Vascular Mapping before Arteriovenous Fistula Surgery for Hemodialysis. Radiology, Available online 21 Jul 2020.