Self-expanding platinum-coated nitinol devices for transcatheter closure of atrial septal defect: prevention of nickel release

J Invasive Cardiol. 2008 Jun;20(6):279-83.

Abstract

Background: A variety of nitinol-containing devices for transcatheter closure of atrial septal defects (ASD) has been widely used. However, there is concern about the release of nickel after nitinol device implantation. In this study, a platinum-coated nitinol device was braided from nanoplatinum-coated nitinol wires in order to prevent nickel release. The serum nickel levels before and after device implantation and the 1-year results were evaluated.

Methods: Thirty-one patients, aged 4-59 years, and weighing 13.7-90.0 kg, underwent transcatheter closure. Blood samples for serum nickel levels were taken before, 1 day, 1 week, 1 month and 3 months after implantation.

Results: Twenty-nine (93.6%) patients had a successful implantation. The mean ASD diameter was 19.7 +/- 4.8 mm (range 10-30 mm). Procedure-related complications included transient brachial plexus injury in 1 patient and transient dysrhythmia in 4 patients. All 29 patients had complete closure within 1 month after implantation. The mean serum nickel levels at baseline and at 1 day, 1 week, 1 month and 3 months after implantation were 0.65 +/- 0.28, 0.63 +/- 0.18, 0.67 +/- 0.34, 0.55 +/- 0.16, 0.52 +/- 0.14 ng/ml, respectively. There was no significant difference in serum nickel levels before and after implantation. There were no device-related complications at 1-year follow up.

Conclusions: Transcatheter ASD closure using a platinum-coated nitinol device can be performed safely and successfully with good outcomes. Nano-coating of platinum on nitinol wires can prevent nickel release following device implantation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Alloys / adverse effects*
  • Cardiac Catheterization / adverse effects*
  • Cardiac Catheterization / instrumentation
  • Child
  • Child, Preschool
  • Female
  • Heart Septal Defects, Atrial / therapy*
  • Humans
  • Hypersensitivity / etiology
  • Hypersensitivity / prevention & control*
  • Male
  • Middle Aged
  • Nickel / adverse effects*
  • Platinum Compounds / adverse effects*
  • Prospective Studies
  • Risk Factors

Substances

  • Alloys
  • Platinum Compounds
  • nitinol
  • Nickel