Blood nickel level and its toxic effect after transcatheter closure of persistent duct arteriosus using Amplatzer duct occluder
Keywords:
patent ductus arteriosus, amplatzer duct occluder, nickel, nitinol, inductively coupled plasma spectrometry
Abstract
Background Transcatheter closure using amplatzer duct occluder(ADO) is currently the treatment of choice for patent ductus
arteriosus (PDA). The ADO device is constructed from a Nitinol
wire mesh containing 55% nickel. Up to now, there is still a
controversy about the effects of nickel contained in ADO.
Objectives To determine blood nickel level at six months after
transcatheter closure of PDA using ADO, toxic effects of nickel
at six months after PDA closure using ADO, and the effects of
nickel on complete blood count (CBC), blood glucose and renal
function.
Methods Subjects were patients with PDA at Integrated
Cardiovascular Services, Dr. Cipto Mangunkusumo Hospital,
Jakarta. Routine blood test and blood nickel levels were measured
at the time of the procedure, and at the end of the first, third, and
sixth months after intervention.
Results There were 29 patients who underwent heart catheteri-
zation and PDA closure using ADO. A time series analysis was
conducted on 23 patients who completed six-month follow-up
after the intervention. Median blood nickel level before procedure
was 58 ng/mL while at one, three and six months afterwards were
60, 63 and 64 ng/mL respectively. The blood nickel levels did
not differ significantly between pre- and post-ADO. After PDA
closure, no toxic effects of nickel were found, both clinically and
laboratorically.
Conclusions PDA closure using ADO has no effects on the nickel
levels, CBC, blood glucose and renal function;
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associated with nickel hypersensitivity to the Amplatzer
occluder device: a case report. Catheterization Cardio-
vascular Interventions. 2005;66:424-6.
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pediatric heart disease- a new therapeutic strategy. Pediatr
Int. 2001;43:527-8.
2. Djer MM, editor. Interventional Pediatric Cardiology in
Indonesia, a multicenter experience. Presented at the
Indonesian National Congress of Child Health (Konika XIII);
2005 July 4-7; Bandung, Indonesia.
3. Paella HJ, Hijazi ZM. Closure of the patent ductus arteriosus
with the Amplatzer PDA device: immediate results of the
international clinical trial. Cathet Cardiovasc Intervent.
2000;52:50-4.
4. Bilkis AA, Alwi M, Samion H, La tiff HA, Kandhavello G,
Rehman MA, et al. The Amplatzer duct occluder: Experience
in 209 patients. JAm Coli Cardiol. 2001;37:258-61.
5. Pass RH, Hijazi ZM, Hsu DT, Lewis V, Hellenbrand WE.
Multicenter USA Amplatzer patent ductus arteriosus
occlusion device trial. Initial and one-year results. J Am Coli
Cardiol. 2004;44:513-9.
6. Shabalovskaya SA. Physicochemical and biological aspect
of Nitinol as a biomaterial. International Materials Review.
2001;46:1-18.
7. Young RA. Toxicity summary for nickel and nickel compounds.
[updated 2006 August !].Available from: http: // www.risk.lsd.
oml.gov / tox / profiles / nickel_ and_ nickel_ compouncls J _ V l.shtml.
8. Trombetta D, Mondello MR, Cimino F, Cristani M, Pergolizzi
S, Saija A. Toxic effect of nickel in an in vitro model of human
oral epithelium. Toxicology Letters. 2005;159:219-25.
9. Costa M, Davidson TL, Haobin C, Qingdong K, Ping Z, Yan
Y, Chuanshu, et al. Nickel carcinogenesis: epigenetics and
hypoxia signaling. Mutation Research. 2005;592:79-88.
10. Zoroddu MA, Schinocca L, Kowalik-Jankowska T, Kozlowski
H, Salnikow K, Costa M. Molecular mechanism in nickel
carcinogenesis: Modeling Ni (II) binding site in histone H4.
Environ Health Perspect. 2002; 110:719-23.
38 • Paediatr Indones, Vol. 49, No. 1, January 2009
11. Coe JY, VanderPluym CJ, editors. Sequential blood nickel
analyses after implantation of Amplatzer septal occluders in
children. Presented at the 14'h Asean Congress of Cardiology;
2002 July 17-21; Kuala Lumpur, Malaysia.
12. Ries MW, Kampmann C, Rupprecht HJ, Hintereder G,
Hafner G, Meyer]. Nickel release after implantation of the
Amplatzer occluder. Am Heart J. 2003; 145:737-41.
13. Lai DW, Saver JL, Araujo JA, Reid! M, Tobis J. Pericarditis
associated with nickel hypersensitivity to the Amplatzer
occluder device: a case report. Catheterization Cardio-
vascular Interventions. 2005;66:424-6.
14. Kirchhof K, Welzel T, Mecke C, Zoubaa S, Sartor K.
Differentiation of white, mixed, and red thrombi: value of
CT in estimation of the prognosis of thrombolysis-Phantom
study. Radiology. 2003;228: 126-30.
15. Joseph G, Mandalay A, Zacharias TU, George B. Severe
intravascular hemolysis after transcatheter closure of a large
patent ductus arteriosus using the Amplatzer Duct Occluder:
successful resolution by intradevice coil deployment. Cather
Cardiovasc Intervent. 2002; 55:245-9.
16. Watts DL. Trace elements and other essential nutrients.
Clinical application of tissue mineral analysis. Dallas: Keller
Springs Road, 1995; p. 167-8.
Published
2009-03-01
How to Cite
1.
Djer M, Madiyono B. Blood nickel level and its toxic effect after transcatheter closure of persistent duct arteriosus using Amplatzer duct occluder. PI [Internet]. 1Mar.2009 [cited 2May2024];49(1):33-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/453
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Received 2016-09-05
Accepted 2016-09-05
Published 2009-03-01
Accepted 2016-09-05
Published 2009-03-01
