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Journal of Long-Term Effects of Medical Implants

Published 4 issues per year

ISSN Print: 1050-6934

ISSN Online: 1940-4379

SJR: 0.184 SNIP: 0.485 CiteScore™:: 1.1 H-Index: 39

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Effect of Vascular Stent Alloys on Expression of Cellular Adhesion Molecules by Endothelial Cells

Volume 15, Issue 1, 2005, pp. 39-48
DOI: 10.1615/JLongTermEffMedImplants.v15.i1.50
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ABSTRACT

Objective. Nickel and cobalt ions activate ICAM1 expression on endothelial cells and keratinocytes. Furthermore, these ions are released in vitro and in vivo from the types of alloys used for vascular stents, but the full biological consequences of this release is not known. In the current study, we determined if release of elements from vascular stent alloys that contained nickel and cobalt was sufficient to activate expression of key cellular adhesion molecules (CAMs) by endothelial cells. Expression of these CAMs is a critical step in the long-term inflammatory response to stent materials and possibly to in-stent restenonsis. Methods. Stainless steel, NiTi, CoCrNi, and NiCr alloys were placed in direct contact with primary human microvascular endothelial cells for 72 hours after preparation at three roughnesses (120, 320, and 1200 grit). Expression of three CAMs—ICAM1, VCAM1, and e-selectin—was assessed using a modified ELISA procedure. Cytotoxicity of the alloys was assessed by measuring succinate dehydrogenase (SDH) activity and total protein content of the cells, and nickel release was measured by atomic absorption spectroscopy. Results. None of the alloys suppressed SDH activity or total cellular protein significantly at any surface roughness, indicating little or no cytotoxicity. Ni release was measurable from all alloys, was greatest from the rougher surfaces, and was significantly different for the different alloy types. NiTi alloys exhibited the lowest nickel release. However, none of the alloys activated expression of the CAMs, regardless of surface roughness or nickel release level. Supplemental experiments using nickel ions alone confirmed that ICAM1 was inducible on the endothelial cells by Ni(II) concentrations above 100 μM. Conclusions. In this in vitro system, nickel or other elemental release from several common types of stent alloys was not sufficient to activate expression of CAMs on endothelial surfaces. Although these results indicate a low risk for direct activation of endothelial cells by ions released from stent alloys, other mechanisms, such as modulation of CAM expression by monocytes or smooth muscle cells, must be considered before ion-mediated influence on CAM expression can be dismissed.

CITED BY
  1. Shih Chun‐Che, Shih Chun‐Ming, Chou Kuang‐Yi, Lin Shing‐Jong, Su Yea‐Yang, Stability of passivated 316L stainless steel oxide films for cardiovascular stents, Journal of Biomedical Materials Research Part A, 80A, 4, 2007. Crossref

  2. McLucas E., Rochev Y., Carroll W. M., Smith T. J., Analysis of the effects of surface treatments on nickel release from nitinol wires and their impact on candidate gene expression in endothelial cells, Journal of Materials Science: Materials in Medicine, 19, 3, 2008. Crossref

  3. Messer Regina L. W., Mickalonis John, Adams Yolanda, Tseng Wan Y., Corrosion rates of stainless steel under shear stress measured by a novel parallel-plate flow chamber, Journal of Biomedical Materials Research Part B: Applied Biomaterials, 76B, 2, 2006. Crossref

  4. Lewis Jill B., Messer Regina L. W., Pitts Leslie, Hsu Stephen D., Hansen Jason M., Wataha John C., Ni(II) ions dysregulate cytokine secretion from human monocytes, Journal of Biomedical Materials Research Part B: Applied Biomaterials, 88B, 2, 2009. Crossref

  5. Choudhary Saba, Berhe Mikal, Haberstroh Karen M, Webster Thomas J, Increased endothelial and vascular smooth muscle cell adhesion on nanostructured titanium and CoCrMo, International Journal of Nanomedicine, 1, 1, 2006. Crossref

  6. Honari Golara, Ellis Stephen G., Wilkoff Bruce L., Aronica Mark A., Svensson Lars G., Taylor James S., Hypersensitivity reactions associated with endovascular devices, Contact Dermatitis, 59, 1, 2008. Crossref

  7. Lifeng Zhao, Yan Hong, Dayun Yang, Xiaoying Lü, Tingfei Xi, Deyuan Zhang, Ying Hong, Jinfeng Yuan, The underlying biological mechanisms of biocompatibility differences between bare and TiN-coated NiTi alloys, Biomedical Materials, 6, 2, 2011. Crossref

  8. Shih Chun-Che, Su Yea-Yang, Chen Lung-Ching, Shih Chun-Ming, Lin Shing-Jong, Degradation of 316L stainless steel sternal wire by steam sterilization, Acta Biomaterialia, 6, 6, 2010. Crossref

  9. Schalock Peter C., Menné Torkil, Johansen Jeanne D., Taylor James S., Maibach Howard I., Lidén Carola, Bruze Magnus, Thyssen Jacob P., Hypersensitivity reactions to metallic implants - diagnostic algorithm and suggested patch test series for clinical use, Contact Dermatitis, 66, 1, 2012. Crossref

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  12. Aliağaoğlu Cihangir, Turan Hakan, Erden İsmail, Albayrak Hülya, Özhan Hakan, Başar Cengiz, Gürlevik Zehra, Alçelik Ayşegül, Relation of Nickel Allergy with in-Stent Restenosis in Patients Treated with Cobalt Chromium Stents, Annals of Dermatology, 24, 4, 2012. Crossref

  13. Aquino Marcella, Mucci Tania, Systemic Contact Dermatitis and Allergy to Biomedical Devices, Current Allergy and Asthma Reports, 13, 5, 2013. Crossref

  14. Klein Catherine, Costa Max, Nickel∗, in Handbook on the Toxicology of Metals, 2015. Crossref

  15. Morshedi Maud M., Kinney Thomas B., Nickel Hypersensitivity in Patients with Inferior Vena Cava Filters: Case Report and Literature and MAUDE Database Review, Journal of Vascular and Interventional Radiology, 25, 8, 2014. Crossref

  16. McLucas E., Moran M. T., Rochev Y., Carroll W. M., Smith T. J., An Investigation into the Effect of Surface Roughness of Stainless Steel on Human Umbilical Vein Endothelial Cell Gene Expression, Endothelium, 13, 1, 2006. Crossref

  17. KLEIN CATHERINE, COSTA MAX, Nickel**Revised and updated from the chapter by Tor Norseth, 1986 edition of this Handbook, in Handbook on the Toxicology of Metals, 2007. Crossref

  18. Konishi Takao, Yamamoto Tadashi, Funayama Naohiro, Yamaguchi Beni, Sakurai Seiichiro, Nishihara Hiroshi, Yamazaki Koko, Kashiwagi Yusuke, Sasa Yasuki, Gima Mitsuru, Tanaka Hideichi, Hotta Daisuke, Kikuchi Kenjiro, Stent thrombosis caused by metal allergy complicated by protein S deficiency and heparin-induced thrombocytopenia: a case report and review of the literature, Thrombosis Journal, 13, 1, 2015. Crossref

  19. O’Brien B., Weafer F.M., Bruzzi M.S., 1.3 Shape Memory Alloys for Use in Medicine ☆, in Comprehensive Biomaterials II, 2017. Crossref

  20. Elesbão João Luiz de Lara, Pereira Adamastor Humberto, Grüdtner Marco Aurélio, Meyer Fabiola, Análise morfométrica da carótida de suínos submetidos a angioplastia com ou sem implante de stent de cromo-cobalto, Jornal Vascular Brasileiro, 9, 2, 2010. Crossref

  21. Panel Pierre, Baissas Pauline, Hysteroscopy in Contraception: Side Effects Review—Is There Really a Problem?, in Hysteroscopy, 2018. Crossref

  22. Jastifer James R., Gustafson Peter A., Silva Luis F., Noffsinger Sarah, Coughlin Michael J., Nitinol, Stainless Steel, and Titanium Kirschner Wire Durability, Foot & Ankle Specialist, 14, 4, 2021. Crossref

  23. Kim Hee Joo, Shin Jung U., Lee Jungsoo, Lee Hemin, Jin Shan, Kim Seo Hyeong, Noh Ji Yeon, Lee Kwang Hoon, Positive Reactions to Nickel on a Patch Test Do Not Predict Clinical Outcome of Nickel Alloy-Based Atrial Septal Defect Occluder Implantation, Dermatology, 230, 2, 2015. Crossref

  24. Cipriano Aaron F., Sallee Amy, Tayoba Myla, Cortez Alcaraz Mayra C., Lin Alan, Guan Ren-Guo, Zhao Zhan-Yong, Liu Huinan, Cytocompatibility and early inflammatory response of human endothelial cells in direct culture with Mg-Zn-Sr alloys, Acta Biomaterialia, 48, 2017. Crossref

  25. Vanent Kevin N, Federico Emma M, Bass David I, Barros Guilherme, Keen Jade, Levitt Michael R, Nickels and tines: the myth of nickel allergy in intracranial stents, Journal of NeuroInterventional Surgery, 2022. Crossref

  26. Klein Catherine B., Costa Max, Nickel, in Handbook on the Toxicology of Metals, 2022. Crossref

  27. Hu Wansong, Jiang Jun, Hypersensitivity and in-stent restenosis in coronary stent materials, Frontiers in Bioengineering and Biotechnology, 10, 2022. Crossref

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