Arterial Imaging of Inflammation and Resolution After Endovascular Surgery

Magnetic resonance imaging (MRI) imaging allows for non-invasive visualization of anatomical
structures while Positron emission tomography (PET) scans allow for the observation of
molecular and cellular activities. Using a PET/MRI in patients with vascular injury post
intervention with help evaluate the vascular inflammatory and resolution response in vivo.

Acute vascular injury through endovascular intervention results in recruitment of
inflammatory cells such as macrophages to the vessel wall. Macrophages are very metabolically
active and consume glucose at a high rate. In PET/MRI, subjects are injected with
18F-Fluorodeoxyglucose (18F-FDG), a radioactively labeled glucose molecule which is consumed
by macrophages.

When 18F-FDG is consumed, it is retained within macrophages more avidly than other
atherosclerotic lesion elements. Thus, FDG-PET provides a unique and noninvasive approach to
quantitatively measure macrophage activity at the intervention site.

This study will provide key pilot data for developing an imaging surrogate endpoint for
pro-resolving mediator treatment intervention trials going forward.

Inclusion Criteria:

- Over the age of 40,

- With resting or exercise ABI <0.9, TBI <0.6

- Have claudication or limb threatening ischemia & planning to undergo a percutaneous
angioplasty of SFA or popliteal artery.

Exclusion Criteria:

- Evidence of active infection

- Hypersensitivity or allergy to contrast agents

- Chronic liver disease, renal disease (GFR< 30) or chronic inflammatory disorders

- Insulin dependent diabetes

- Presence of metal within subject's body, pacemakers, or defibrillators

- BMI < 20 or >35

- Recent other major surgery or illness within 30 days

- Use of immunosuppressive medications or steroids

- History of organ transplantation

- Pregnancy, or plans to become pregnant, or lactating