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Surgical implants
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Staples:

 

Small internal staples, which remain in the body after surgery, are frequently made from titanium. They may be used in a variety of procedures from tubal ligation (sterilisation), Laparoscopic surgery (gall bladder removal) and bariatric surgery (eg “stomach stapling”)

 

Stents:

 

Self-expandable metallic stents are often coated with titanium (in the form of Nitinol). These stents may be used in gastro surgery and also in cardio surgery. Increasingly, titanium clips and stents are used in bariatric surgery.

 

Very little research has been conducted into titanium stents, however there appears to be a link between metal allergy and restenosis, which is the recurrence of a narrowing of the blood vessels.Increased rate of restenosis has been reported in patients fitted with gold-plated stents who were suffering from gold allergy. The same was reported for nickel-cobalt stents used in nickel or cobalt allergic patient.

 

 

Pacemakers:

 

Most pacemakers are housed in a titanium shell, or the wires (or both) may be made from titanium.

 

Below is a link to an abstract about suspected titanium allergy in a patient with a pacemaker. When the titanium pacemaker was replaced with polyurethane leads the wound healed. In other cases, other metals such as nickel, can be the culprit. For example, as described in detail in the Patients’ stories section of this website, one patient developed arthritis after the placement of a pacemaker with stainless steel electrode leads. After removal of the leads, his arthritis disappeared. The MELISA test confirmed allergy to nickel and molybdenum, metals which are present in stainless steel alloys.

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