Aneurysm clip motion during magnetic resonance imaging: in vivo experimental study with metallurgical factor analysis

Because of various mechanical, metallurgical, and commercial constraints, aneurysm clips are manufactured from different alloys, including several stainless steel and cobalt alloys. Some of the steels contain volume fractions of the crystal phase known as martensite. Martensitic alloys have body-centered cubic structure, are prone to stress corrosion failure, and are ferromagnetic. Martensitic steel can be displaced like a compass needle when exposed to a magnetic field such as that generated during magnetic resonance imaging (MRI). The force exerted by the magnetic field is proportional to the volume fraction of the magnetic phase. We investigated the martensitic content and magnetic field-induced displacement of 12 common aneurysm clips. Four clips of each of the following types were examined: Sugita, Sundt-Kees Multi-Angle, Heifetz (two types), Vari-Angle McFadden, Yasargil (two types), Scoville, Mayfield, Vari-Angle, Pivot, and Kapp. Phase homogeneity and crystal structure were analyzed by x-ray diffraction using a Phillips x-ray diffractometer. Clip deflection in an Oxford Research Systems MRI spectrometer was measured in our in vivo rat abdominal aortic aneurysm model. Results showed that the volume fraction of the martensitic phase in the various clips correlated with the magnitude of the deflection. Among the clips examined, the Yasargil, Sugita, Heifetz Elgiloy, and Vari-Angle McFadden had a nonmartensitic composition and did not deflect in the magnetic field. The Scoville contained 5% martensite and deflected only marginally. Martensite comprised 35% of the Mayfield clip, which deflected 45 degrees, and 90% of the Heifetz, Vari-Angle, Pivot, and Sundt-Kees Multi-Angle clips, which deflected approximately 70 degrees or slipped off the aneurysm.(ABSTRACT TRUNCATED AT 250 WORDS)