Superelastic wires and diamond-shaped stent surrogates were manufactured from Nitinol rods and tubing, respectively, from five different mill product suppliers - Standard VAR, Standard VIM, Standard VIM+VAR, Process-Optimized VIM+VAR, and High-Purity VAR. High-cycle fatigue tests up to 10(7) cycles were conducted under tension-tension conditions for wires and bending conditions for diamonds. These materials were compared under both testing methods at 37°C with 6% prestrain and 3% mean strain (unloading plateau) with a range of alternating strains.
View Article and Find Full Text PDFA 46-year-old woman underwent inferior vena cava filter placement before bariatric surgery and returned within 6 months for routine removal. She complained of a 1-week history of severe chest pain, and during retrieval, two fractured filter components were identified including one arm in the right ventricle. The filter body and one fragment were successfully retrieved, but the fragment in the right ventricle was refractory to percutaneous retrieval.
View Article and Find Full Text PDFThe bending fatigue resistance of commercially-available Standard versus High Purity Nitinol was evaluated at 3% mean strain and a range of strain amplitudes with the simple wire Z-specimen geometry. The Standard grade Nitinol demonstrated a 10(7)-cycle fatigue strain limit of 0.50% alternating strain, comparable to results reported elsewhere in the literature.
View Article and Find Full Text PDFA 48-year-old man presented with symptomatic inferior vena cava (IVC) occlusion from a chronically thrombosed and embedded Vena Tech LGM filter resulting in exercise intolerance from diminished cardiac preload and postthrombotic syndrome from chronic venous insufficiency. The patient was treated using a new PRIME technique--Piecemeal Removal by Intentional MEchanical fracture--to achieve successful filter retrieval 16 years after implantation. Removal of the obstructing filter permitted endovascular IVC recanalization with restoration of venous outflow and alleviation of venous obstructive symptoms.
View Article and Find Full Text PDFPurpose: To evaluate clinical outcomes, characterize adherent tissue, and analyze inferior vena cava (IVC) filter fractures in patients undergoing complex retrieval for management of filter-related complications. To elucidate mechanisms of filter fracture by radiographic and electron microscopic (EM) evaluation.
Materials And Methods: Over 2.
Purpose: To examine the effects of swallowing and side-to-side head turning on stents in the internal carotid artery.
Methods: Seven patients (4 men; mean age 76.9 years) who underwent carotid artery stenting for the treatment of atherosclerotic cervical carotid artery disease were examined with cine fluoroscopy.
J Vasc Interv Radiol
January 2009
Purpose: To report on the evaluation and management of Bard Recovery filter limb perforation, fracture, and migration.
Materials And Methods: In 2007, all patients who received a Bard Recovery filter at a single institution were contacted for consultation and evaluation by noncontrast computed tomography. Rates of limb perforation, fracture, and migration were evaluated on early (<180 days) and final images.
The authors describe an incident of a type I single strut fracture in a right renal artery (RRA) stent resulting in approximately 90% restenosis. Fracture was observed just distal to the ostium approximately 1 year after implantation in an 83-year-old man with a history of systemic cardiovascular disease. In addition, a statistical analysis of the clinically reported cases of left renal artery (LRA) and RRA stent fracture is provided, which suggests a greater susceptibility to fracture in LRA stents as demonstrated by the greater occurrence (67%) in the left side.
View Article and Find Full Text PDFEndovascular stents made of the superelastic nickel-titanium alloy Nitinol are subjected in service to tens of millions of loading cycles and even "single-event" overloads, both of which can potentially result in fracture and/or complete failure of the device. A fracture-mechanics-based methodology can provide a means to quantify relevant material parameters critical to the design against such failures. However, there is a dearth of relevant experimental data in the literature on such fracture-mechanics-based approaches to fatigue in Nitinol; furthermore, that which does exist invariably pertains to product forms that are not appropriate for stent manufacture, e.
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