Implants and contact allergy: are sensitizing metals released as haptens from coronary stents?
BACKGROUND
The possible impact of metal release from coronary artery stents has, with their increased use, become a concern.


OBJECTIVE
To study in vitro metal release in biologically relevant milieu from coronary stents made of different alloys.


METHODS
Coronary stents in common use in a department of cardiology at the time of the study were tested. A previously described in vitro technique was used, whereby the stents were kept in the extraction media for a week. Two different extraction media were used to show the necessity of studying the actual biological surrounding of the implant when metal release is investigated. Metal release was determined with atomic absorption spectrometry.


RESULTS
In this study, we show metal release from stents after immersion in extraction media of artificial sweat and cysteine solution, as illustrative media.


CONCLUSIONS
Metal release from coronary stents is shown. The magnitude of release is influenced by several factors. The extent to which metal release in vitro has potential biological effects, in terms of elicitation of an allergic reaction or induction of sensitization, in vivo needs to be explored. However, as metal release from an implant in a biologically appropriate medium has been established, better risk assessments in relation to delayed hypersensitivity may be undertaken.
Department of Occupational Environmental Dermatology, Skåne University Hospital, Lund University, 205 02 Malmö, Sweden.
Cecilia
C
Svedman
Halvor
H
Möller
Birgitta
B
Gruvberger
Carl-Gunnar
CG
Gustavsson
Jakob
J
Dahlin
Lena
L
Persson
Magnus
M
Bruze
D003331:Coronary Vessels; D017449:Dermatitis, Allergic Contact / Q000209:etiology*; D006241:Haptens / Q000009:adverse effects* / Q000032:analysis*; D006801:Humans; D008670:Metals / Q000009:adverse effects* / Q000032:analysis*; D013054:Spectrophotometry, Atomic; D015607:Stents / Q000009:adverse effects*
D006241:Haptens; D008670:Metals
contact allergy; implant; metal release; stent