Correspondence Marc Gewillig MD, PhD, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. Email: [email protected]Search for more papers by this author

Bjorn Cools MD,

Bjorn Cools MD

Pediatric and Congenital Cardiology, UZ Leuven, Leuven, Belgium

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Stephen Brown MD, PhD,

Stephen Brown MD, PhD

Pediatric and Congenital Cardiology, UZ Leuven, Leuven, Belgium

Pediatric Cardiology, University of the Free State, Bloemfontein, South Africa

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Martine Wevers PhD,

Martine Wevers PhD

Department of Metallurgy and Materials Engineering, University of Leuven, Leuven, Belgium

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Jan Van Humbeeck PhD,

Jan Van Humbeeck PhD

Department of Metallurgy and Materials Engineering, University of Leuven, Leuven, Belgium

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Derize Boshoff MD PhD,

Derize Boshoff MD PhD

Pediatric and Congenital Cardiology, UZ Leuven, Leuven, Belgium

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Cis Verdonckt MSc,

Cis Verdonckt MSc

Corrosion Engineering, Metalogic, Rotselaar, Belgium

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Marc Gewillig MD, PhD,

Corresponding Author

Marc Gewillig MD, PhD

[email protected]

orcid.org/0000-0002-4595-5922

Pediatric and Congenital Cardiology, UZ Leuven, Leuven, Belgium

Correspondence Marc Gewillig MD, PhD, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. Email: [email protected]Search for more papers by this author

First published: 12 September 2017

https://doi.org/10.1002/ccd.27320

Citations: 5

Funding information: Eddy Merckx Research Foundation; Sporta MonVentoux Research grant

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Abstract

Background

The aim of this study was to assess the resistance to compression (stiffness) of frequently used stents for right ventricular outflow tract prestenting. In addition, to assess the corrosion potential when different types of stent alloys come into contact with each other.

Method

Different stents were tested in vitro in various combinations at specialized metallurgic laboratories. A bench compression test was used to assess resistance to compression of singular and joined combinations of stents. Corrosion was evaluated by standardized electrochemical galvanic tests in physiological solutions at 37°C. Single stents and combinations of stents were evaluated over a period of 4–12 weeks.

Results

Relative stiffness of the stents Optimus/Andrastent XXL/Intrastent LD Max/8zig Cheatham-Platinum, expressed as load per length to deform the stent for 1 mm at 22 mm was 100/104/161/190. Adding additional stents to a single stent significantly strengthened the joined couples (P < 0.001). The lowest galvanic corrosion rates (about 0.000001 mm/year) were observed for the joined CP-Andrastent, Andra-Sapien, and Andra-SapienXT. The corrosion rate for coupled CP-Sapien and CP-SapienXT was somewhat higher (about 0.000003 mm/year). The materials with the highest corrosion rates resulted in material losses of, respectively, 17 and 24 µg/year, which is negligible over a lifetime.

Conclusion

Adding stents to a single stent significantly increases stiffness which will reduce the risk of metal fatigue failure. Corrosion of individual stents or stent combinations occurs, but is negligible over a human lifetime with low risk of biological effects. No mechanical integrity problems are thus expected as there is only 0.3% of the initial diameter of the struts of a stent that will be lost as a consequence of corrosion after 100 years.

CONFLICT OF INTEREST

Marc Gewillig is proctor for Numed, Medtronic, and Edwards.

Supporting Information

REFERENCES

1 Nordmeyer J, Coats L, Lurz P, Lee TY, Derrick G, Rees P, Cullen S, Taylor AM, Khambadkone S, Bonhoeffer P. Percutaneous pulmonary valve-in-valve implantation: A successful treatment concept for early device failure. Eur Heart J 2008; 29: 810–815.
10.1093/eurheartj/ehn073
PubMed Web of Science® Google Scholar
2 Nordmeyer J, Khambadkone S, Coats L, Schievano S, Lurz P, Parenzan G, Taylor AM, Lock JE, Bonhoeffer P. Risk stratification, systematic classification, and anticipatory management strategies for stent fracture after percutaneous pulmonary valve implantation. Circulation 2007; 115: 1392–1397.
10.1161/CIRCULATIONAHA.106.674259
PubMed Web of Science® Google Scholar
3 McElhinney DB, Cheatham JP, Jones TK, Lock JE, Vincent JA, Zahn EM, Hellenbrand WE. Stent fracture, valve dysfunction, and right ventricular outflow tract reintervention after transcatheter pulmonary valve implantation: Patient-related and procedural risk factors in the us melody valve trial. Circ Cardiovasc Interv 2011; 4: 602–614.
10.1161/CIRCINTERVENTIONS.111.965616
PubMed Web of Science® Google Scholar
4 Armstrong AK, Balzer DT, Cabalka AK, Gray RG, Javois AJ, Moore JW, Rome JJ, Turner DR, Zellers TM, Kreutzer J. One-year follow-up of the melody transcatheter pulmonary valve multicenter post-approval study. JACC Cardiovasc Interv 2014; 7: 1254–1262.
10.1016/j.jcin.2014.08.002
PubMed Web of Science® Google Scholar
5 Schievano S, Petrini L, Migliavacca F, Coats L, Nordmeyer J, Lurz P, Khambadkone S, Taylor AM, Dubini G, Bonhoeffer P. Finite element analysis of stent deployment: Understanding stent fracture in percutaneous pulmonary valve implantation. J Interv Cardiol 2007; 20: 546–554.
10.1111/j.1540-8183.2007.00294.x
CAS PubMed Google Scholar
6 Cheatham JP, Hellenbrand WE, Zahn EM, Jones TK, Berman DP, Vincent JA, McElhinney DB. Clinical and hemodynamic outcomes up to 7 years after transcatheter pulmonary valve replacement in the us melody valve investigational device exemption trial. Circulation 2015; 131: 1960–1970.
10.1161/CIRCULATIONAHA.114.013588
PubMed Web of Science® Google Scholar
7 Zahn EM, Hellenbrand WE, Lock JE, McElhinney DB. Implantation of the melody transcatheter pulmonary valve in patients with a dysfunctional right ventricular outflow tract conduit early results from the U.S. Clinical trial. J Am Coll Cardiol 2009; 54: 1722–1729.
10.1016/j.jacc.2009.06.034
PubMed Web of Science® Google Scholar
8 McElhinney DB, Hellenbrand WE, Zahn EM, Jones TK, Cheatham JP, Lock JE, Vincent JA. Short- and medium-term outcomes after transcatheter pulmonary valve placement in the expanded multicenter US melody valve trial. Circulation 2010; 122: 507–516.
10.1161/CIRCULATIONAHA.109.921692
PubMed Web of Science® Google Scholar
9 Cools BBW, Heying R, Boshoff D, Eyskens B, Frerich S, Troost E, Gewillig M. Medium term follow-up after percutaneous pulmonary valve replacement with the melody valve. Int J Cardiol Heart Vasculature 2015; 7: 92–97.
10.1016/j.ijcha.2015.02.014
Google Scholar
10 Kazimierczak A, Podraza W, Lenart S, Wiernicki I, Gutowski P. Electrical potentials between stent-grafts made from different metals induce negligible corrosion. Eur J Vasc Endovasc Surg 2013; 46: 432–437.
10.1016/j.ejvs.2013.06.010
Google Scholar
11 Madl AK, Kovochich M, Liong M, Finley BL, Paustenbach DJ, Oberdorster G. Toxicology of wear particles of cobalt-chromium alloy metal-on-metal hip implants part II: Importance of physicochemical properties and dose in animal and in vitro studies as a basis for risk assessment. Nanomed Nanotechnol Biol Med 2015; 11: 1285–1298.
10.1016/j.nano.2015.02.006
CAS PubMed Web of Science® Google Scholar
12 Mullins CE, O'Laughlin MP, Vick GW, 3rd, Mayer DC, Myers TJ, Kearney DL, Schatz RA, Palmaz JC. Implantation of balloon-expandable intravascular grafts by catheterization in pulmonary arteries and systemic veins. Circulation 1988; 77: 188–199.
10.1161/01.CIR.77.1.188
CAS PubMed Web of Science® Google Scholar
13 Palmaz JC. Balloon-expandable intravascular stent. Am J Roentgenol 1988; 150: 1263–1269.
10.2214/ajr.150.6.1263
CAS PubMed Web of Science® Google Scholar
14 Palmaz JC, Richter GM, Noeldge G, Schatz RA, Robison PD, Gardiner GA, Jr., Becker GJ, McLean GK, Denny DF, Jr., Lammer J, et al. Intraluminal stents in atherosclerotic iliac artery stenosis: Preliminary report of a multicenter study. Radiology 1988; 168: 727–731.
10.1148/radiology.168.3.2970098
CAS PubMed Web of Science® Google Scholar
15 Venugopalan R. Corrosion testing of stents: A novel fixture to hold entire device in deployed form and finish. J Biomed Mater Res 1999; 48: 829–832.
10.1002/(SICI)1097-4636(1999)48:6<829::AID-JBM10>3.0.CO;2-#
CAS PubMed Web of Science® Google Scholar
16 Shabalovskaya S, Anderegg J, Van Humbeeck J. Critical overview of nitinol surfaces and their modifications for medical applications. Acta Biomater 2008; 4: 447–467.
10.1016/j.actbio.2008.01.013
CAS PubMed Web of Science® Google Scholar
17 Shabalovskaya S, Anderegg J, Rondelli G, Vanderlinden W, De Feyter S. Comparative in vitro performances of bare nitinol surfaces. Biomed Mater Eng 2008; 18: 1–14.
Google Scholar
18 Mueller Y, Tognini R, Mayer J, Virtanen S. Anodized titanium and stainless steel in contact with cfrp: An electrochemical approach considering galvanic corrosion. J Biomed Mater Res A 2007; 82: 936–946.
Google Scholar
19 Paprottka KJ, Paprottka PM, Reiser MF, Waggershauser T. Comparative study of the corrosion behavior of peripheral stents in an accelerated corrosion model: Experimental in vitro study of 28 metallic vascular endoprostheses. Diagn Interv Radiol 2015; 21: 403–409.
Google Scholar
20 Schievano S, Taylor AM, Capelli C, Lurz P, Nordmeyer J, Migliavacca F, Bonhoeffer P. Patient specific finite element analysis results in more accurate prediction of stent fractures: Application to percutaneous pulmonary valve implantation. J Biomech 2010; 43: 687–693.
10.1016/j.jbiomech.2009.10.024
PubMed Web of Science® Google Scholar
21 Nordmeyer J, Lurz P, Khambadkone S, Schievano S, Jones A, McElhinney DB, Taylor AM, Bonhoeffer P. Pre-stenting with a bare metal stent before percutaneous pulmonary valve implantation: Acute and 1-year outcomes. Heart 2011; 97: 118–123.
10.1136/hrt.2010.198382
PubMed Web of Science® Google Scholar
22 Ashbey MSH, Cebon D. Materials: Science, Processing and Design. Canada: Elsevier; 2009.
Google Scholar
23 Cosentino D, Quail MA, Pennati G, Capelli C, Bonhoeffer P, Diaz-Zuccarini V, Taylor AM, Schievano S. Geometrical and stress analysis of factors associated with stent fracture after melody percutaneous pulmonary valve implantation. Circ Cardiovasc Interv 2014; 7: 510–517.
10.1161/CIRCINTERVENTIONS.113.000631
PubMed Web of Science® Google Scholar
24 Chakfe N, Heim F. Commentary on 'electrical potentials between stent-grafts made from different metals induce negligible corrosion'. Eur J Vasc Endovasc Surg 2013; 46: 438–439.
10.1016/j.ejvs.2013.07.009
Google Scholar
25 Ries MW, Kampmann C, Rupprecht HJ, Hintereder G, Hafner G, Meyer J. Nickel release after implantation of the amplatzer occluder. Am Heart J 2003; 145: 737–741.
10.1067/mhj.2003.7
CAS PubMed Web of Science® Google Scholar
26 Muller B, Ghawi H, Heitschmidt MG, Fogg L, Hibbeln J, Hijazi ZM, Kenny D. Medium-term CT evaluation of stent geometry, integrity, and valve function of the Edwards Sapien transcatheter heart valve in the pulmonary position. Catheter Cardiovasc Interv 2016; 87: E97–103.
10.1002/ccd.26074
PubMed Web of Science® Google Scholar

Citing Literature

Volume91, Issue2

February 1, 2018

Pages 285-291

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Right ventricle outflow tract prestenting: In vitro testing of rigidity and corrosion properties

Abstract

Background

Method

Results

Conclusion

CONFLICT OF INTEREST

Supporting Information

REFERENCES

Citing Literature

References

Information

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Right ventricle outflow tract prestenting: In vitro testing of rigidity and corrosion properties

Abstract

Background

Method

Results

Conclusion

CONFLICT OF INTEREST

Supporting Information

REFERENCES

Citing Literature

References

Related

Information