nitinol and Foreign-Bodies

The aim of this in vitro study was to evaluate the effects on root dentin of 2 trephining techniques using an ultrasonic tip or a trepan bur in the mesial canals of mandibular molars during attempts to remove fractured file fragments using micro-computed tomographic imaging.. Twenty-one teeth with a similar anatomic configuration in mesial (buccal and lingual) canals were selected. A 4-mm apical segment of K3 file size 25/.06 was fractured in each mesiobuccal and mesiolingual canal 5 mm apically from the canal orifice. A staging platform was prepared at the coronal aspect of the broken instrument followed by either ultrasonics or a new trepan bur technique to expose a 1- to 1.5-mm length of the fragment. If the broken instrument could not be removed by exposing it either by ultrasound or the trepan bur, a microtube device was used to attach to and withdraw the fragment. Micro-CT scanning was performed before and after removing the broken instrument. Canal volume, diameter, and furcal root dentin thickness were measured by using image analysis software. The time required for the removal of the instrument fragments was recorded. The result was statistically analyzed using the paired t test.. The trepan bur technique had significantly less impact on canal volume, diameter, and furcal root dentin thickness change than the ultrasonic technique (P < .001). The time consumed for successful removal of the fragments was significantly less in the trepan bur group (8.9 ± 3.5 minutes) than in the ultrasonic group (25 ± 11.9 minutes) (P < .001).. A new small-sized trepan bur technique was superior to the use of ultrasound with regard to the amount of dentin removed and the speed in the removal of fractured instruments from root canals.

Topics: Alloys; Dental Instruments; Dental Pulp Cavity; Equipment Failure; Foreign Bodies; Humans; In Vitro Techniques; Molar; Root Canal Preparation; Ultrasonography

Two dogs were referred to the Kansas State University Veterinary Medical Teaching Hospital for pulmonary arterial embolization and one to Washington State University Veterinary Teaching Hospital for right heart embolization of jugular catheter fragments. Endovascular retrieval of foreign bodies was accomplished under general anesthesia in all three cases. Although the incidence of, and complications associated with catheter embolization in dogs are unknown, it appears that they can be safely and easily retrieved with a nitinol gooseneck snare.

Topics: Alloys; Animals; Catheterization; Device Removal; Dogs; Female; Foreign Bodies; Jugular Veins; Male; Treatment Outcome

Topics: Alloys; Catheterization, Peripheral; Equipment Design; Femoral Artery; Foreign Bodies; Hemostasis, Surgical; Humans; Peripheral Vascular Diseases; Surgical Staplers; Surgical Stapling; Titanium

From various points of view abandoned or displaced permanent pacemaker leads should be extracted in indicated cases using a broad spectrum of catheter-based techniques. We describe a relatively easy extraction procedure of almost the whole pacemaker lead, which broke near the pulse generator and migrated into right-heart chambers; so both ends were indwelling. The described procedure was undertaken using a simple homemade nitinol-based extractor.

Topics: Aged; Aged, 80 and over; Alloys; Device Removal; Electrodes, Implanted; Equipment Failure; Foreign Bodies; Humans; Male; Pacemaker, Artificial; Sick Sinus Syndrome

to evaluate the efficacy and advantages of the snare systems in the retrieval of foreign bodies from vascular system.. the snare technique has been used for intravascular foreign body retrieval. We performed percutaneous extraction of intravascular foreign bodies using combination multipurpose catheters and a nitinol snare loop. In this report, we evaluated the patients who had performed endovascular device reposition or foreign body retrieval from 1998 to 2001.. foreign body retrieval was performed in 15 patients. The foreign bodies consisted of seven fractured port catheters, one sheath fragment, one embolization coil, four wire fragments, one pace-maker transducer and one dislocated endovascular stent. In no case were surgical procedures required, and no complications were encountered.. the snare technique is a useful and a safe method as an alternative procedure to surgery. This technique is highly effective with low rate complications.

Topics: Adolescent; Adult; Aged; Alloys; Angiography; Blood Vessels; Catheterization; Catheters, Indwelling; Equipment Failure; Foreign Bodies; Heart Atria; Humans; Middle Aged; Radiology, Interventional; Retrospective Studies; Stents; Treatment Outcome

With the progress of interventional procedures the need for retrieval of iatrogenic materials increases. Here we introduce a new nitinol micro-forceps for retrieval of intravascular objects and report our first in-vitro experiences.. In a tube model simulating arterial anatomy a total of eight endovascular coils were removed from the "carotid artery" using a "trans-femoral" approach. Additionally, the withdrawal of grasped coils through vascular sheaths of F-5, F-6, F-8, F-12 was observed (n = 4/seize).. Seven of 8 coils were successfully grasped. Loss of one coil occurred during retrieval. Withdrawal of coils through a vascular sheath was possible only when the coil was grasped at one of its ends.. The nitinol micro-forceps proved to be a potential tool in endovascular retrieval of foreign objects especially in small caliber vessels. However, further technical modifications are necessary to improve maneuverability and grasping strength.

Topics: Alloys; Arteries; Equipment Design; Foreign Bodies; Humans; In Vitro Techniques; Models, Anatomic; Surgical Instruments; Treatment Outcome; Veins

Endotracheal intubation of premature infants with respiratory distress is a commonly performed procedure in the neonatal intensive care unit. We report a rare complication of this procedure, shearing of the plastic sheath that is bonded to and surrounds the stylet used to assist intubation and lodging of the sheared stylet in the tracheobronchial tree of a small premature infant. We suggest a method for removing the plastic foreign body using fluoroscopy and an Amplatz gooseneck snare directed through the existing endotracheal tube, a technique not previously reported.

Topics: Alloys; Female; Fluoroscopy; Foreign Bodies; Humans; Infant, Newborn; Infant, Premature; Intraoperative Complications; Intubation, Intratracheal; Radiology, Interventional

Percutaneous endoscopic gastrostomy (PEG) is a safe method with a low complication rate for providing enteral nutrition. While the "pull" method is the standard technique for PEG placement, alternatively "push" methods were developed in order to minimize peristomal wound infections caused by micro-organisms from the oropharyngeal cavity. Intragastral fixation of the "push" type PEG tube has always been a problem. The MEMOSOND-PEG uses a heat activated nitinol memory spiral as an anchor-like intragastral fixation. So far, an intraabdominal dislocation and a perforation have been reported as severe complications of this type of PEG tube. Five years after insertion we observed the development of an abscess induced by ingrowth of a nitinol spiral into the stomach wall as a further fatal complication in a patient with a MEMOSOND-PEG. The memory metal spiral had pierced the stomach wall after partial destruction of the polyurethane covering. The nitinol spiral was endoscopically extracted in several fragments. Ten days after extraction however, the patient died of combined kidney and liver failure due to a sepsis with Staphylococcus.

Topics: Abdominal Abscess; Alloys; Carcinoma, Squamous Cell; Combined Modality Therapy; Enteral Nutrition; Equipment Failure; Fatal Outcome; Foreign Bodies; Gastrostomy; Humans; Male; Middle Aged; Mouth Neoplasms; Neoplasm Recurrence, Local; Prosthesis-Related Infections; Staphylococcal Infections; Stomach

The authors describe their use of a new right-angle snare made of nickel-titanium (nitinol) cable for retrieval of foreign bodies and iatrogenically placed devices. The snare loop is at right angles to the cable and comes in five sizes (5, 10, 15, 25, and 35 mm); its radiographic visualization is enhanced by gold-plated tungsten coils. This snare was used to retrieve wire and catheter fragments introduced into the thoracic vasculature of four dogs. Eleven of 13 attempts were successful. Three attempts to retrieve intravascular foreign bodies were successful in two patients; in one of these patients, a 10-mm snare was used to remove a fractured end of a ventriculoatrial shunt tube from the left pulmonary artery. In three other patients, four ureteral stents were successfully removed under fluoroscopic guidance. All retrievals were performed through a vascular sheath and with standard techniques and angiographic equipment. No complications were seen in any of the patients or dogs.

Topics: Alloys; Angiography; Animals; Blood Vessels; Catheterization; Dogs; Equipment Design; Fluoroscopy; Foreign Bodies; Humans; Stents; Ureter