Influence of Nitinol wire surface treatment on oxide thickness and composition and its subsequent effect on corrosion resistance and nickel ion release

Biocompatible antibiotic-coupled nickel-titanium nanoparticles as a potential coating material for biomedical devices

The challenges facing metallic implants for reconstructive surgery include the leaching of toxic metal ions, a mismatch in elastic modulus between the implant and the treated tissue, and the risk of infection. These problems can be addressed by passivating the metal surface with an organic substrate and incorporating antibiotic molecules. Nitinol (NiTi), a nickel-titanium alloy, is used in devices for biomedical applications due to its shape memory and superelasticity. However, unmodified NiTi carries a risk of localized nickel toxicity and inadequately supports angiogenesis or neuroregeneration due to limited cell adhesion, poor biomineralization, and little antibacterial activity. To address these challenges, NiTi nanoparticles were modified using self-assembled phosphonic acid monolayers and functionalized with the antibiotics ceftriaxone and vancomycin via the formation of an amide. Surface modifications were monitored to confirm that phosphonic acid modifications were present on NiTi nanoparticles and 100% of the samples formed ordered films. Modifications were stable for more than a year. Elemental composition showed the presence of nickel, titanium, and phosphorus (1.9% for each sample) after surface modifications. Dynamic light scattering analysis suggested some agglomeration in solution. However, scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy confirmed a particle size distribution of <100 nm, the even distribution of nanoparticles on coverslips, and elemental composition before and after cell culture. B35 neuroblastoma cells exhibited no inhibition of survival and extended neurites of approximately 100 μm in total length when cultured on coverslips coated with only poly-l-lysine or with phosphonic acid-modified NiTi, indicating high biocompatibility. The ability to support neural cell growth and differentiation makes modified NiTi nanoparticles a promising coating for surfaces in metallic bone and nerve implants. NiTi nanoparticles functionalized with ceftriaxone inhibited Escherichia coli and Serratia marcescens (SM6) at doses of 375 and 750 μg whereas the growth of Bacillus subtilis was inhibited by a dose of only 37.5 μg. NiTi-vancomycin was effective against B. subtilis at all doses even after mammalian cell culture. These are common bacteria associated with infected implants, further supporting the potential use of functionalized NiTi in coating reconstructive implants.

Porous NiTi Dental Implant Fabricated by a Metal Injection Molding: An in Vivo Biocompatibility Evaluation in an Animal Model

This study assessed the corrosion resistance, intracutaneous reactivity, acute systemic toxicity, and in situ tissue effect of the implantation of porous NiTi fabricated by metal injection molding in animal models. For the intracutaneous reactivity study, five intracutaneous injections were administered per site with and without the tested extract in polar and nonpolar solutions. The extract was also delivered via intravenous and intraperitoneal routes for acute systemic toxicity. TiAl6 V4 (control) and porous NiTi were implanted in rabbit femora for a period of 13 weeks to evaluate the in situ tissue response. Corrosion was evaluated through open and cyclic polarization in PBS, while biocompatibility was investigated by assessing the general conditions, skin irritation score (edema and erythema), and histopathology. No active dissolution or hysteresis loop was observed in the corrosion study. None of the animals exhibited death, moribundity, impending death, severe pain, self-mutilation, or overgrooming. No edema was observed at injection sites. Only the positive control showed an erythematous reaction at 24, 48, and 72 h observations (p < 0.001). Porous NiTi showed a low in situ biological response for inflammation, neovascularization, and fibrosis in comparison to the control implant (p = 0.247, 0.005, and 0.011, respectively). Porous NiTi also demonstrated high pitting corrosion resistance while causing no acute hypersensitivity or acute systemic toxicity. The study concludes that porous NiTi implants were unlikely to cause local sensitization, acute systemic toxicity, or chronic inflammatory reactions in an animal model. Porous NiTi also exhibited osseointegration equivalent to Ti6AI4 V of known biocompatibility.

Surface finishing of Nitinol for implantable medical devices: A review

Nitinol (NiTi), a nickel-titanium alloy, has been used for various cardiovascular, orthopedic, fracture fixation, and orthodontic devices. As with most other metallic biomaterials, the corrosion resistance and biocompatibility of NiTi are primarily determined by the properties of the surface oxide layer such as thickness, chemical composition, structure, uniformity, and stability. Currently, a number of finishing methods are used to improve the properties of surface oxide of NiTi with an ultimate goal to produce a defect-free, impurity-free, thin homogeneous oxide layer that is stable and composed of only titanium dioxide (TiO₂ ) with negligible amount of Ni species. This review discusses the effects of various surface finishing methods such as mechanical polishing, electropolishing, magnetoelectropolishing, heat treatments at different temperatures, passivation, chemical etching, boiling in water, hydrogen peroxide treatment, and sterilization techniques (steam autoclave, ethylene oxide, dry heat, peracetic acid, and plasma-based treatments) on the properties of a surface oxide layer and how it impacts the corrosion resistance of NiTi. Considering the findings of the literature review, a checklist has been provided to assist with choosing finishing/sterilization methods and relevant rationale and recommendations to consider when selecting a surface finishing process for NiTi used in implantable medical devices.

In vitro wearing away of orthodontic brackets and wires in different conditions: A review

Introduction

The release of metallic ions from orthodontic brackets and wires typically depends on their quality (chemical composition) and the medium to which they are exposed, e.g., acidic, alkaline, substances with a high fluoride concentration, etc. This review examines corrosion and wear of orthodontic brackets, wires, and arches exposed to different media, including: beverages (juices), mouthwashes and artificial saliva among others, and the possible health effects resulting from the release of metallic ions under various conditions.

Objective

This review aims to determine the exposure conditions that cause the most wear on orthodontic devices, as well as the possible health effects that can be caused by the release of metallic ions under various conditions.

Sources

A search was carried out in the Scopus database, for articles related to oral media that can corrode brackets and wires. The initial research resulted in 8,127 documents, after applying inclusion and exclusion criteria, 76 articles remained.

Conclusion

Stainless steel, which is commonly used in orthodontic devices, is the material that suffers the most wear. It was also found that acidic pH, alcohols, fluorides, and chlorides worsen orthodontic material corrosion. Further, nickel released from brackets and wires can cause allergic reactions and gingival overgrowth into patients.

Nitinol Release of Nickel under Physiological Conditions: Effects of Surface Oxide, pH, Hydrogen Peroxide, and Sodium Hypochlorite

Nitinol is a nickel-titanium alloy widely used in medical devices for its unique pseudoelastic and shape-memory properties. However, nitinol can release potentially hazardous amounts of nickel, depending on surface manufacturing yielding different oxide thicknesses and compositions. Furthermore, nitinol medical devices can be implanted throughout the body and exposed to extremes in pH and reactive oxygen species (ROS), but few tools exist for evaluating nickel release under such physiological conditions. Even in cardiovascular applications, where nitinol medical devices are relatively common and the blood environment is well understood, there is a lack of information on how local inflammatory conditions after implantation might affect nickel ion release. For this study, nickel release from nitinol wires of different finishes was measured in pH conditions and at ROS concentrations selected to encompass and exceed literature reports of extracellular pH and ROS. Results showed increased nickel release at levels of pH and ROS reported to be physiological, with decreasing pH and increasing concentrations of hydrogen peroxide and NaOCl/HOCl having the greatest effects. The results support the importance of considering the implantation site when designing studies to predict nickel release from nitinol and underscore the value of understanding the chemical milieu at the device-tissue interface.

Temperature dependence of nickel ion release from nitinol medical devices

Nitinol exhibits unique (thermo)mechanical properties that make it central to the design of many medical devices. However, nitinol nominally contains 50 atomic percent nickel, which if released in sufficient quantities, can lead to adverse health effects. While nickel release from nitinol devices is typically characterized using in vitro immersion tests, these evaluations require lengthy time periods. We have explored elevated temperature as a potential method to expedite this testing. Nickel release was characterized in nitinol materials with surface oxide thickness ranging from 12 to 1564 nm at four different temperatures from 310 to 360 K. We found that for three of the materials with relatively thin oxide layers, ≤ 87 nm nickel release exhibited Arrhenius behavior over the entire temperature range with activation energies of 80 to 85 kJ/mol. Conversely, the fourth ''black-oxide'' material, with a much thicker, complex oxide layer, was not well characterized by an Arrhenius relationship. Power law release profiles were observed in all four materials; however, the exponent from the thin oxide materials was approximately 1/4 compared with 3/4 for the black-oxide material. To illustrate the potential benefit of using elevated temperature to abbreviate nickel release testing, we demonstrated that a > 50 day 310 K release profile could be accurately recovered by testing for less than 1 week at 340 K. However, because the materials explored in this study were limited, additional testing and mechanistic insight are needed to establish a protective temperature scaling that can be applied to all nitinol medical device components.

Reduction in nickel content of the surface oxide layer on Ni-Ti alloy by electrolytic treatment

PURPOSE

Ni-Ti alloy has been increasingly applied to dental and medical devices, however, it contains nickel, which is known to have adverse effects on the human body. The purpose of this study was to form a nickel-free surface oxide layer on Ni-Ti alloy by electrolytic treatment for better biocompatibility.

METHODS

Ni-49.15Ti (mol%) alloy was used, and the electrolytic treatment was performed in the electrolytes under 50 V for 30 minutes. The electrolytes were composed of lactic acid, water, and glycerol with different compositions. Surface analysis and characterization of Ni-Ti alloy were carried out by means of X-ray photoelectron spectroscopy (XPS) and Auger electron spectroscopy (AES).

RESULTS

Results indicated that the outmost surface oxide layer was nickel-free when using an electrolyte comprising 7.1% lactic acid, 57.2% water, and 35.7% glycerol by volume. The composition of this nickel-free surface oxide layer was determined as TiO_1.92(OH)_1.35 ∙ 0.43H₂O by XPS, similar to that of unalloyed titanium. The thickness of this nickel-free layer was estimated at 6.4 nm by AES.

CONCLUSION

The nickel-free surface oxide layer produced on Ni-Ti alloy is considered to improve the biocompatibility of medical and dental devices having shape memory effect and/or super-elasticity.

Corrosion resistance of a Nitinol ocular microstent: Implications on biocompatibility

Nitinol is commonly used in medical implants due to its unique thermomechanical properties of shape memory and superelasticity. Free nickel has the potential to induce biological responses that may be a concern for permanent implants manufactured from nickel-containing alloys. Although there are extensive reports on the effects of surface treatments on corrosion behavior in cardiovascular Nitinol implants, there is a lack of data on corrosion resistance and impact on biocompatibility for ocular implants. Therefore, the objective of this study was to determine localized corrosion and nickel elution resistance of an electropolished Nitinol-based ocular device (Hydrus Microstent, Ivantis, Inc.) intended for patients with primary open angle glaucoma. Pitting corrosion susceptibility was characterized by potentiodynamic polarization testing per ASTM F2129. In addition, nickel ion release was quantified with immersion testing to 63 days. The results indicated high localized corrosion resistance as all samples reached polarization potentials of 800 mV without pitting initiation. Maximum nickel elution rates per device were less than approximately 1.1 ng/device/day after the first day of immersion and reduced to less than 0.1 ng/device/day after 7 days. For a patient with bilateral microstents, these nickel concentrations are ×10,000 lower than previously published tolerable intake levels for systemic toxicity. Overall, these corrosion results are in good agreement with literature values of well processed and biocompatible Nitinol devices indicating adverse systemic biological responses are not expected in vivo.

Effect of Ni ion release on the cells in contact with NiTi alloys

Nickel-titanium alloys have been used in medical applications for several years; however, biocompatibility of the material remains controversial. In the present study, the human umbilical vein endothelial cells (HUVEC) were cultured in contact with the nitinol used in two different heat treatment  surface modifications-helium and hydrogen. The amount of Ni ions released from these alloys in contact with HUVEC was measured in media and in the cells by ICP-MS. An increased release of Ni ions was detected in He alloy compared with H₂ alloy modification with an elevation with the metal exposition duration (24 h vs. 72 h). The cells contained the Ni ions in both selected alloy modifications with the lower levels in H₂ alloys. To evaluate the potential of multiple metal applications, similar values were observed in media and in cell suspension for all surface modification combinations. The model analysis of effect of metal ion release on distant cells in the body showed that the concentration is interestingly similar to concentrations in cells in direct contact with the metal alloy. The cells are able to regulate the concentration of Ni ions within the cell. According to our best knowledge, the study for the first time describes the presence of Ni ions released from nitinol directly in the cells. In the case of the H₂ modification, the lowest levels of Ni ions were detected both in medium and in the cells, which likely increases the biocompatibility of the nitinol alloy.

Characterisation of NiTi Orthodontic Archwires Surface after the Simulation of Mechanical Loading in CACO2-2 Cell Culture

Nickel-titanium (NiTi) orthodontic archwires are crucial in the initial stages of orthodontic therapy when the movement of teeth and deflection of the archwire are the largest. Their great mechanical properties come with their main disadvantage—the leakage of nickel. Various in vitro studies measured nickel leakage from archwires that were only immersed in the medium with little or minimal simulation of all stress and deflection forces that affect them. This study aims to overcome that by simulating deflection forces that those archwires are exposed to inside the mouth of a patient. NiTi orthodontic archwires were immersed in CACO2-2 cell culture medium and then immediately loaded while using a simulator of multiaxial stress for 24 h. After the experiment, the surface of the NiTi orthodontic archwires were analysed while using scanning electron microscopy (SEM) and auger electron spectroscopy (AES). The observations showed significant microstructural and compositional changes within the first 51 nm thickness of the archwire surface. Furthermore, the released nickel and titanium concentrations in the CACO2-2 cell culture medium were measured while using Inductively Coupled Plasma Mass Spectroscopy (ICP-MS). It was found out that the level of released nickel ions was 1.310 µg/L, which can be assigned as statistically significant results. These data represent the first mention of the already detectable release of Ni ions after 24 h during the simulation of mechanical loading in the CACO2-2 cell culture medium, which is important for clinical orthodontic praxis.

In vitro investigation of chemical properties and biocompatibility of neurovascular braided implants

Braiding of Nitinol micro wires is an established technology for the manufacturing of fine-meshed neurovascular implants for tortuous vessel geometries. Electropolishing of wires before the braiding process has the potential to improve the in vitro behaviour in terms of thrombogenicity and endothelial cell proliferation. In this study, we present the first in vitro investigation of braided electropolished/blue oxide Nitinol samples in a blood flow loop, showing a significantly lower activation of the coagulation pathway (represented by the TAT III marker) and a tendency towards reduced platelet adhesion. Furthermore, we applied the same surface treatment on flat disks and measured protein adhesion as well as endothelial cell proliferation. We compared our results to non-electropolished samples with a native oxide surface. While platelet deposition was reduced on electropolished/blue oxide surface, a significant increase of endothelial cell seeding was observed. Investigation of inflammatory marker expression in endothelial cells provided divergent results depending on the marker tested, demanding closer investigation. Surface analysis using Auger electron spectroscopy revealed a thin layer mainly consisting of titanium oxynitride or titanium oxide + titanium nitride as a potential cause of the improved biological performance. Translated to the clinical field of intracranial aneurysm treatment, the improved biocompatibility has the potential to increase both safety (low thrombogenicity) and effectiveness (aneurysm neck reconstruction).

Effect of Ta2O5 content on the osseointegration and cytotoxicity behaviors in hydroxyapatite-Ta2O5 coatings applied by EPD on superelastic NiTi alloys

In the present study, the different contents of tantalum pentoxide (Ta₂O₅: 10, 15, 20 and 30 wt%) nanoparticles were introduced into the natural hydroxyapatite (nHA) coating structure on NiTi substrate through electrophoretic deposition (EPD) method. The phase compositions of coatings were perused before and after the sintering at 800 °C for 1 h by XRD. The incorporation of 30wt%Ta₂O₅ into nHA matrix induced the formation of undesirable soluble Ca₃(PO₄)₂ phase in composite coating. The FESEM images showed that the density of continuous nHA coating increased by compositing with Ta₂O₅. The maximum adhesion strength of 28.3 ± 0.7 MPa accomplished from the nHA-20 wt%Ta₂O₅ composite coating. The Ni ions concentration measurement results from the passivated-NiTi with nHA and nHA-(10, 15 and 20)wt%Ta₂O₅ coatings during 30 days of immersion in PBS clarified the positive role of Ta₂O₅ in decreasing the Ni leaching due to the lowering the open porosities of nHA structure. The biological response of the coating surfaces was assessed in vitro by cell culturing and MTS assay. By considering the morphology and density of adsorbed cells on each coating, the improved biocompatibility of nHA coating in the presence of Ta₂O₅ was justified by scrutinizing the surface roughness, wettability and charge. The highest cell attachment and proliferation on nHA-20 wt%Ta₂O₅ coating was related to owning the lowest roughness, wetting angle of 34^o ± 0.5 and the highest negative surface charge density. Also, the concentration of the highest negative charge density on nHA-20 wt%Ta₂O₅ coating surface in the SBF solution caused to the enhancement of the amount of the apatite nuclei through providing more sites to calcium absorption.

Serum Nickel and Titanium Levels after Transcatheter Closure of Atrial Septal Defects with Amplatzer Septal Occluder

Introduction

There is a concern about release of nickel and titanium after implantation of nitinol-containing devices.

Objective

To evaluate serum nickel and titanium release after implantation of Amplatzer occluder.

Materials and methods

In 38 pediatric patients with no history of nickel sensitivity, blood samples were drawn 24 hours before and 24 hours, 1, 3, 6, and 12 months after implantation. Nickel and titanium concentrations were measured by atomic absorption spectrophotometry.

Results

The median serum nickel level which was 0.44 ng/mL before the implantation increased to 1.01 ng/mL 24 hours after implantation and 1.72 ng/mL one month after implantation. The maximum level was detected 3 months after implantation, with a median level of 1.96 ng/mL. During follow-up, the nickel levels decreased to those measured before implantation. Serum nickel levels at the 24th hour, 1st month, and 3rd month following implantation were found to have increased significantly. No patients showed a detectable serum titanium level.

Discussion

This is the first study that evaluated both serum nickel and titanium release after implantation of the Amplatzer occluder. Our study shows that nickel is released from the device in the first few months after implantation. Therefore, in patients with nickel allergy, other devices may be considered.

The occurrence of neointimal hyperplasia after flow-diverter implantation is associated with cardiovascular risks factors and the stent design

Background

Neo-intimal hyperplasia (NIH) is frequently observed after flow-diverter stent (FDS) implantation. Although mostly asymptomatic, this vascular response can sometimes lead to delayed ischemic strokes. This study intended to evaluate the factors potentially influencing the rates of NIH following FDS treatment.

Material and Methods

All aneurysm treatments performed with a Pipeline embolization device (PED) or a SILK stent from May 2011 to May 2015 were collected in a prospectively maintained database. Patient demographics, clinical, and angiographic outcomes including both digital subtraction angiography and C-arm cone-beam CT were registered. Two blind reviewers rated the presence of NIH on a binary scale (present/absent).

Results

From 148 patients, 63 datasets were available for analysis. Inter-reader agreement was excellent (Kappa=0.88). NIH was positively correlated with smoking, dyslipidemia, and high blood pressure, but not with aneurysm characteristics. At early follow-up (<12 months), NIH was more frequently associated with the use of the SILK stent (68%) rather than the PED (38%): P<0.02. At long-term follow-up, the NIH rate in the total population dropped from 55% to 26% with no more significant difference between the two stents. The complete occlusion rate as seen in early follow-up was higher in the SILK group with 76% vs 65% but without statistical significance (P=0.4).

Conclusion

NIH is a dual-vessel reaction after FDS implant. When planning a treatment in locations at risk of ischemic complications if severe NIH would occur, then the stent design should be considered. However, minimal NIH might also be needed as it is involved in aneurysm healing. Before treatment patients should be recommended best medical management of their cardiovascular risks factors to prevent an excessive NIH reaction.

The use of electrochemical techniques to evaluate the corrosion performance of metallic biomedical materials and devices

The corrosion performance of metallic biomedical materials and devices is commonly evaluated using electrochemical techniques. Although test standards involving such techniques have been released to address some forms of corrosion, a key issue is application of the results with regard to use of an implantable device in vivo. This review focuses on nitinol, 316L/LVM stainless steel, and Co-Cr alloys and is intended to provide some perspective on the significance of results from tests concerning general corrosion, localized corrosion, galvanic corrosion, and fretting corrosion of these alloys in simulated physiological solutions. It also examines the factors that could cause differences in the corrosion performance between in vitro and in vivo exposure, with the goal of providing some rationale for applying electrochemical characteristics obtained from the tests to predict the corrosion performance in vivo. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1189-1198, 2019.

Impact of nitinol stent surface processing on in-vivo nickel release and biological response

Although nitinol is widely used in percutaneous cardiovascular interventions, a causal relationship between nickel released from implanted cardiovascular devices and adverse systemic or local biological responses has not been established. The objective of this study was to investigate the relationship between nitinol surface processing, in-vivo nickel release, and biocompatibility. Nitinol stents manufactured using select surface treatments were implanted into the iliac arteries of minipigs for 6 months. Clinical chemistry profile, complete blood count, serum and urine nickel analyses were performed periodically during the implantation period. After explant, stented arteries were either digested and analyzed for local nickel concentration or fixed and sectioned for histopathological analysis of stenosis and inflammation within the artery. The results indicated that markers for liver and kidney function were not different than baseline values throughout 180 days of implantation regardless of surface finish. In addition, white blood cell, red blood cell, and platelet counts were similar to baseline values for all surface finishes. Systemic nickel concentrations in serum and urine were not significantly different between processing groups and comparable to baseline values during 180 days of implantation. However, stents with non-optimized surface finishing had significantly greater nickel levels in the surrounding artery compared to polished stents. These stents had increased stenosis with potential for local inflammation compared to polished stents. These findings demonstrate that proper polishing of nitinol surfaces can reduce in-vivo nickel release locally, which may aid in minimizing adverse inflammatory reactions and restenosis.

STATEMENT OF SIGNIFICANCE

Nitinol is a commonly used material in cardiovascular medical devices. However, relationships between nitinol surface finishing, in-vivo metal ion release, and adverse biological responses have yet to be established. We addressed this knowledge gap by implanting single and overlapped nitinol stents with different surface finishes to assess systemic impact on minipigs (i.e. serum and urine nickel levels, liver and kidney function, immune and blood count) over the 6 month implantation period. In addition, nickel levels and histopathology in stented arteries were analyzed on explant to determine relationships between surface processing and local adverse tissue reactions. The findings presented here highlight the importance of surface processing on in-vivo nickel release and subsequent impact on local biological response for nitinol implants.

The effects of surface processing on in-vivo corrosion of Nitinol stents in a porcine model

A major limitation with current assessments of corrosion in metallic medical devices is the lack of correlation between in-vitro and in-vivo corrosion performance. Therefore, the objective of this study was to elucidate the relationship between pitting corrosion measured by breakdown potentials (E_b) in ASTM F2129 testing and corrosion resistance in-vivo. Four groups of Nitinol stents were manufactured using different processing methods to create unique surface properties. The stents were implanted into iliac arteries of minipigs for six months and explanted for corrosion analysis. Scanning electron microscopy and energy dispersive X-ray spectrometry analyses indicated that stents with a thick complex thermal oxide (420nm) and high corrosion resistance in-vitro (E_b=975±94mV) were free from detectable corrosion in-vivo and exhibited no changes in Ni/Ti ratio when compared to non-implanted controls. This result was also found in mechanically polished stents with a thin native oxide (4nm; E_b=767±226mV). In contrast, stents with a moderately thick thermal oxide (130nm) and low corrosion resistance in-vitro (E_b=111±63mV) possessed corrosion with associated surface microcracks in-vivo. In addition, Ni/Ti ratios in corroded regions were significantly lower compared to non-corroded adjacent areas on explanted stents. When stents were minimally processed (i.e. retained native tube oxide from the drawing process), a thick thermal oxide was present (399nm) with low in-vitro corrosion resistance (E_b=68±29mV) resulting in extensive in-vivo pitting. These findings demonstrate that functional corrosion testing combined with a detailed understanding of the surface characteristics of a Nitinol medical device can provide insight into in-vivo corrosion resistance.

STATEMENT OF SIGNIFICANCE

Nitinol is a commonly used material in the medical device industry. However, correlations between surface processing of nitinol and in-vivo corrosion has yet to be established. Elucidating the link between in-vivo corrosion and pre-clinical characterization can aid in improved prediction of clinical safety and performance of nitinol devices. We addressed this knowledge gap by fabricating nitinol stents to possess distinct surface properties and evaluating their corrosion susceptibility both in-vitro and after six months of in-vivo exposure. Relationships between stent processing, surface characterization, corrosion bench testing, and outcomes from explanted devices are discussed. These findings highlight the importance of surface characterization in nitinol devices and provide in-vitro pitting corrosion levels that can induce in-vivo corrosion in nitinol stents.

Sodium Hypochlorite Treatment and Nitinol Performance for Medical Devices

Processing of nitinol medical devices has evolved over the years as manufacturers have identified methods of reducing surface defects such as inclusions. One recent method proposes to soak nitinol medical devices in a 6% sodium hypochlorite (NaClO) solution as a means of identifying surface inclusions. Devices with surface inclusions could in theory then be removed from production because inclusions would interact with NaClO to form a visible black material on the nitinol surface. To understand the effects of an NaClO soak on performance, we compared as-received and NaClO-soaked nitinol wires with two different surface finishes (black oxide and electropolished). Pitting corrosion susceptibility was equivalent between the as-received and NaClO-soaked groups for both surface finishes. Nickel ion release increased in the NaClO-soaked group for black oxide nitinol, but was equivalent for electropolished nitinol. Fatigue testing revealed a lower fatigue life for NaClO-soaked black oxide nitinol at all alternating strains. With the exception of 0.83% alternating strain, NaClO-soaked and as-received electropolished nitinol had similar average fatigue life, but the NaClO-soaked group showed higher variability. NaClO-soaked electropolished nitinol had specimens with the lowest number of cycles to fracture for all alternating strains tested with the exception of the highest alternating strain 1.2%. The NaClO treatment identified only one specimen with surface inclusions and caused readily identifiable surface damage to the black oxide nitinol. Damage from the NaClO soak to electropolished nitinol surface also appears to have occurred and is likely the cause of the increased variability of the fatigue results. Overall, the NaClO soak appears to not lead to an improvement in nitinol performance and seems to be damaging to the nitinol surface in ways that may not be detectable with a simple visual inspection for black material on the nitinol surface.

The electrochemical behavior of nitinol in simulated gastric fluid

Increased use is being made of nitinol for implants that are exposed to gastric fluid. However, few corrosion studies have involved nitinol in an appropriate acidified chloride solution. In this work, the electrochemical behavior of electropolished (EP) nitinol was examined in simulated gastric fluid, the corresponding neutral solution with the same concentration (0.6%) of NaCl, and 0.9% NaCl. Cyclic potentiodynamic polarization was used to evaluate the susceptibility to pitting corrosion, while electrochemical impedance spectroscopy was used to examine the passive oxide film. The potentiodynamic tests showed that the susceptibility of EP nitinol to pitting corrosion is affected by chloride concentration and pH. Acidification, in particular, resulted in the susceptibility being markedly higher in gastric fluid compared with that in the corresponding neutral NaCl solution. The impedance data could be fitted using a parallel resistance-capacitance (as a constant phase element) circuit associated with the oxide film. The thickness of the oxide was determined from the capacitive component and found to be little affected by chloride concentration. In contrast, acidification increased the solubility of the oxide enough to decrease the thickness of the film from 5.3 nm in 0.6% NaCl to 4.2 nm in gastric fluid. The resistivity of the oxide obtained from the resistance was affected by chloride concentration (0.7 × 10¹¹ and 1.7 × 10¹¹ Ω m in 0.9% and 0.6% NaCl, respectively) and particularly by pH (6.3 × 10¹¹ Ω m in gastric fluid). The resistivity values suggest that the oxide was more defective in the neutral solutions. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B:2394-2400, 2017.

Surface characteristics, corrosion and bioactivity of chemically treated biomedical grade NiTi alloy

The surface of NiTi alloy was chemically modified using acidified ferric chloride solution and the characteristics of the alloy surface were studied from the view point of application as a bioimplant. Chemically treated NiTi was also subjected to post treatments by annealing at 400°C and passivation in nitric acid. The surface of NiTi alloy after chemical treatment developed a nanogrid structure with a combination of one dimensional channel and two dimensional network-like patterns. From SEM studies, it was found that the undulations formed after chemical treatment remained unaffected after annealing, while after passivation process the undulated surface was filled with oxides of titanium. XPS analysis revealed that the surface of passivated sample was enriched with oxides of titanium, predominantly TiO2. The influence of post treatment on the corrosion resistance of chemically treated NiTi alloy was monitored using Potentiodynamic Polarization and Electrochemical Impedance Spectroscopy (EIS) in Phosphate Buffered Saline (PBS) solution. In the chemically treated condition, NiTi alloy exhibited poor corrosion resistance due to the instability of the surface. On the other hand, the breakdown potential (0.8V) obtained was highest for the passivated samples compared to other surface treated samples. During anodic polarization, chemically treated samples displayed dissolution phenomenon which was predominantly activation controlled. But after annealing and passivation processes, the behavior of anodic polarization was typical of a diffusion controlled process which confirmed the enhanced passivity of the post treated surfaces. The total resistance, including the porous and barrier layer, was in the range of mega ohms for passivated surfaces, which could be attributed to the decrease in surface nickel content and formation of compact titanium oxide. The passivated sample displayed good bioactivity in terms of hydroxyapatite growth, noticed after 14days immersion in Hanks' solution.

Effect of thermomechanical pre-treatment on short- and long-term Ni release from biomedical NiTi

The effect of annealing and deformation on short-term (21days) and long-term (8months) Ni release from biomedical NiTi wires is studied. The deformation of annealed NiTi wires causes cracking and flaking of the surface oxide layer. Flaking of oxide particles does not uncover the Ni-rich layer underneath the surface oxide layer, since at sites where flaking occurs, a thin (∼25nm) layer of oxide remains on top of this Ni-rich layer. The number of cracks in the oxide and Ni-rich layer, respectively, increases with deformation, and intercrystalline crack propagation into the Ni-rich layer and the NiTi bulk is observed. In plastically deformed wires, the cracks may remain opened, providing access of immersion liquid to these zones. Characteristics and quantity of short-term Ni release are significantly affected by the pre-deformation, resulting in an up to 2 times higher total Ni release within the first 21days of deformed compared to annealed wires. Pre-deformation does not significantly influence long-term Ni release; all annealed and deformed samples exhibit similar long-term Ni release rates. The source of Ni during short-term release is the Ni contained in the surface zone of the oxide layer. For high pre-deformation, the Ni-rich layer is a second source for Ni. This second source is also the cause for Ni release in long-term immersion experiments.

Biological response of endothelial cells to diamond-like carbon-coated NiTi alloy

Diamond-like carbon (DLC) coatings were deposited on nearly equiatomic nickel-titanium (NiTi) alloy by arc-enhanced magnetron sputtering. The microstructure, surface morphology, chemical composition, surface free energy, protein adsorbance, and leach amount of Ni ions were assessed by Raman spectroscopy, high-resolution transmission electron microscopy (HR-TEM), atomic force microscopy (AFM), X-ray photoelectron spectroscopy (XPS), contact angle measurements, micro BCA™ protein assay kit, and inductively coupled plasma mass spectrometry (ICP-MS). The biological response of the endothelial cells (ECs) was evaluated by cell adhesion, morphology, viability, and expression levels of thrombogenicity-related genes. Our results show that the DLC coatings inhibit the release of Ni ions from the NiTi substrate effectively thus enhancing its biosafety. The easy adhesion, elongated morphology, and high viability of ECs on the DLC coatings suggest fast endothelialization after implantation and so application of DLC coatings improves the surface properties of NiTi in cardiovascular applications. The relationship between the surface characteristics, Ni leaching, and concomitant biological response are discussed in details.

Induction heating vs conventional heating for the hydrothermal treatment of nitinol and its subsequent 2-(methacryloyloxy)ethyl 2-(trimethylammonio)ethyl phosphate coating by surface-initiated atom transfer radical polymerization

Nitinol is an alloy of great interest in general and especially in the biomedical field where many researches are aimed to improve both its corrosion resistance and its biocompatibility. In this work, we report on the advantage of an induction heating treatment in pure water compared to a conventional hydrothermal procedure. Both treatments lead to a hydroxylation of the surface, a decrease of the nickel amount in the outer part of the oxide layer, and a drastically decreased corrosion current density. However, the amount of surface hydroxyl groups is higher in the case of the induction heating treatment, which in turn leads to a denser grafting of atom transfer radical polymerization initiators and ultimately to a thicker 2-(methacryloyloxy)ethyl 2-(trimethylammonio)ethyl phosphate (MPC) polymer layer than in the case of conventional heating treatments. X-ray photoelectron spectroscopy (XPS), static contact angle, and polarization curves measurements as well as scanning electron microscopy (SEM) have been used to characterize the obtained modified surfaces.

Stability of Ni in nitinol oxide surfaces

The stability of Ni in titanium oxide surface layers on nitinol wires known to release certain amounts of Ni was investigated by first principles density functional theory and transmission electron microscopy. The oxides were identified as a combination of TiO and TiO(2) depending on the thickness of the layer. The calculations indicate that free Ni atoms can exist in TiO at ambient temperature while Ni particles form in TiO(2), which was confirmed by the transmission electron microscopy observations. The results are discussed with respect to surface stability and Ni release due to free Ni atoms and Ni particles.

Understanding organic film behavior on alloy and metal oxides

Native oxide surfaces of stainless steel 316L and Nitinol alloys and their constituent metal oxides, namely nickel, chromium, molybdenum, manganese, iron, and titanium, were modified with long chain organic acids to better understand organic film formation. The adhesion and stability of films of octadecylphosphonic acid, octadecylhydroxamic acid, octadecylcarboxylic acid, and octadecylsulfonic acid on these substrates were examined in this study. The films formed on these surfaces were analyzed by diffuse reflectance infrared Fourier transform spectroscopy, contact angle goniometry, atomic force microscopy, and matrix-assisted laser desorption ionization mass spectrometry. The effect of the acidity of the organic moiety and substrate composition on the film characteristics and stability is discussed. Interestingly, on the alloy surfaces, the presence of less reactive metal sites does not inhibit film formation.

The electrochemical characteristics of native Nitinol surfaces

The present study explored the avenues for the improvement of native Nitinol surfaces for implantation obtained using traditional procedures such as mechanical polishing, chemical etching, electropolishing and heat treatments for a better understanding of their electrochemical behavior and associated surface stability, conductivity, reactivity and biological responses. The corrosion resistance (cyclic potential polarization, open circuit potential and polarization resistance) of Nitinol disc and wire samples were evaluated for various surface states in strain-free and strained wire conditions. The surface response to tension strain was studied in situ. Surface chemistry and structure were explored using XPS and Auger spectroscopy and photoelectrochemical methods, respectively. It was found that the polarization resistance of the Nitinol surfaces varied in a range from 100 kOmega to 10 MOmega cm(2) and the open circuit potentials from -440 mV to -55 mV. The surfaces prepared in chemical solutions showed consistent corrosion resistance in strain-free and strained states, but mechanically polished and heat treated samples were prone to pitting. Nitinol surface oxides are semiconductors with the band gaps of either 3.0 eV (rutile) or 3.4 eV (amorphous). The conductivity of semiconducting Nitinol surfaces relevant to their biological performances is discussed in terms of oxide stoichiometry and variable Ni content. Such biological characteristics of Nitinol surfaces as Ni release, fibrinogen adsorption and platelets behavior are re-examined based on the analysis of the results of the present study.

Microstructure of surface and subsurface layers of a Ni-Ti shape memory microwire

The microstructure of a 55 microm diameter, cold-worked Ni-Ti microwire is investigated by different transmission electron microscopy techniques. The surface consists of a few hundred nanometer thick oxide layer composed of TiO and TiO2 with a small fraction of inhomogeneously distributed Ni. The interior of the wire has a core-shell structure with primarily B2 grains in the 1 microm thick shell, and heavily twinned B19' martensite in the core. This core-shell structure can be explained by a concentration gradient of the alloying elements resulting in a structure separation due to the strong temperature dependence of the martensitic start temperature. Moreover, in between the B2 part of the metallic core-shell and the oxide layer, a Ni3Ti interfacial layer is detected.

Polystyrene formation on monolayer-modified nitinol effectively controls corrosion

A surface-initiated polymerization of styrene on carboxylic acid terminated phosphonic monolayers was utilized to increase the corrosion resistance of nitinol and nickel oxide surfaces. Alkyl chain ordering, organic reactions, wettability, and film quality of the monolayers and polymers were determined by infrared spectroscopy, atomic force microscopy, matrix-assisted laser desorption ionization spectrometry, and water contact angles. The polystyrene film proved to be a better corrosion barrier than phosphonic acid monolayers by analysis with cyclic voltammetry and electrochemical impedance spectroscopy. The protection efficiency of the polystyrene film on nitinol was 99.4% and the monolayer was 42%.

Critical overview of Nitinol surfaces and their modifications for medical applications

Nitinol, a group of nearly equiatomic shape memory and superelastic NiTi alloys, is being extensively explored for medical applications. Release of Ni in the human body, a potential problem with Nitinol implant devices, has stimulated a great deal of research on its surface modifications and coatings. In order to use any of the developed surfaces in implant designs, it is important to understand whether they really have advantages over bare Nitinol. This paper overviews the current situation, discusses the advantages and disadvantages of new surfaces as well as the limitations of the studies performed. It presents a comprehensive analysis of surface topography, chemistry, corrosion behavior, nickel release and biological responses to Nitinol surfaces modified mechanically or using such methods as etching in acids and alkaline solutions, electropolishing, heat and ion beam treatments, boiling in water and autoclaving, conventional and ion plasma implantations, laser melting and bioactive coating deposition. The analysis demonstrates that the presently developed surfaces vary in thickness from a few nanometers to micrometers, and that they can effectively prevent Ni release if the surface integrity is maintained under strain and if no Ni-enriched sub-layers are present. Whether it is appropriate to use various low temperature pre-treatment protocols (< or = 160 degrees C) developed originally for pure titanium for Nitinol surface modifications and coatings is also discussed. The importance of selection of original Nitinol surfaces with regard to the performance of coatings and comparative performance of controls in the studies is emphasized. Considering the obvious advantages of bare Nitinol surfaces for superelastic implants, details of their preparation are also outlined.

Effect of nitinol wire surface properties on albumin adsorption

The superelastic, shape memory alloy nitinol ( approximately 50% nickel and approximately 50% titanium) is an important medical device material used for stent applications. However, the role specific surfaces properties have in protein adsorption remain controversial. In this study the effects of nitinol wire surface roughness, hydrophobicity and elemental composition upon albumin adsorption are investigated. In particular, we demonstrate that the technique of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry in the so-called surface mode can be used for the direct detection of albumin on the wire surfaces. In addition, albumin adsorbing to the wires was determined by using (125)I-labelled albumin. Albumin was detected on all wire samples. Surface roughness and hydrophobicity appeared to have no effect on albumin adsorption. There was however a clear correlation between the surface nickel and oxygen concentration and the amount of albumin adsorbed. Samples with higher levels of nickel and less oxygen in the surface oxide layer of the wires showed increased albumin adsorption, which could lead to improved biocompatibility. However, nickel is a toxic substance and can cause many adverse effects on humans, and thus nitinol with a slightly enriched surface nickel concentration that does not exhibit nickel release may have potential as a medical device material.