Dissolution of tungsten coils does not produce systemic toxicity, but leads to elevated levels of tungsten in the serum and recanalization of the previously occluded vessel
Aim: To evaluate the failure of mechanically detachable spirals produced from tungsten (MDS, Balt, Montmorency, France) and the toxicity of elevated levels of tungsten in the serum subsequent to their implantation. Methods: We reviewed findings in 21 patients in whom tungsten coils had been used to occlude pathologic vessels, aneurysms and fistulas between 1996 and 1999. We achieved clinical follow-up, and measured renal and hepatic function, in 14 of the 21 patients. Results: Decreased radiopacity of the coils was observed in 9 of 13 patients who had follow-up fluoroscopy during repeat cardiac catheterization. Repeat angiography of the vessel occluded by the coil was performed in 7 patients, 5 of whom showed recanalization. Levels of tungsten in the serum were analyzed 6 to 35 months after implantation of coils in 8 patients. The mean concentration was 6.43 µg/l, with a range from 2 to 14.4 µg/l, normal values being less than 0.2 µg/l. Conclusion: Tungsten coils may dissolve over time and lead to markedly elevated levels of tungsten in the serum, with recanalization of previously occluded vessels. Despite lack of clinical and laboratory data in patients with elevated levels of tungsten in the serum, our study suggests that the clinical use of mechanically detachable coils produced from tungsten should no longer be recommended.(Published Online August 15 2006)
(Accepted January 4 2002)
Key Words: Aneurysm; carotid artery; arteriovenous malformation; embolization; interventional radiology.
c1 Correspondence to: Dr med. Matthias Peuster, Department of Pediatric Cardiology and Pediatric Intensive Care, Georg-August University, Robert-Koch-Str. 40, D-37075 Goettingen, Germany. Tel: + 49 551 39 6203; Fax: +49 551 39 12774; E-mail: email@example.com
a It is with great regret that we report that Professor Hausdorf died subsequent to the completion of this manuscript.