Can Heart Stents Safely Undergo MRI Scans? A Patient's Dilemma

Can a patient with a stent installed during cardiac catheterization undergo an MRI examination?

Dear Director Wang,
I am a heart disease patient who had three coronary stents implanted at Medical Center A in mid-March 2017.
Additionally, I am receiving treatment for cervical and lumbar osteophyte issues (degenerative spondylosis with radiculopathy) at the rehabilitation department of Medical Center B.
Due to worsening pain, the rehabilitation department recommended an MRI examination.

Here is my concern: I noticed the contraindications on the examination order, which state that if there are implanted devices in the body, MRI scans may not be suitable.
However, it did not specifically mention coronary stents.
I consulted with the rehabilitation physician, who advised me to ask a cardiologist.
Later, I visited the cardiology department at Medical Center A, where the cardiologist informed me that older MRI machines were not safe, but newer models are acceptable.
He suggested I inquire with the laboratory at Medical Center B.
When I arrived at the laboratory, the staff informed me that they use a 1.5T MRI machine (I believe this refers to the magnetic field strength of the MRI machine, which can range from 0.75 to 7T).
They also stated that a diagnostic certificate from the cardiology department at Medical Center A was required for the examination due to liability concerns.
I provided them with an example from National Taiwan University Hospital, which indicated that a nitinol-based occluder could undergo MRI scans below 2T.
I immediately rushed back to the cardiology department at Medical Center A and showed the example to the doctor.
After checking, the doctor confirmed that my coronary stents are made of cobalt-chromium alloy (drug-eluting stents).
The cardiologist also consulted with their own laboratory, which indicated that MRI scans could be performed eight weeks after the stent implantation.
They recommended that I continue my treatment at the rehabilitation department of Medical Center A, stating that the laboratory at Medical Center B was merely shifting responsibility.
As a patient, I do not wish to offend the physicians or laboratory staff, but I am unclear about the risks involved.
What criteria should I consider to determine whether I can undergo the MRI? 1.
What is the material of the stent? (During the stent placement, they only inquired about whether it was drug-eluting or not, and I am unaware of the alloy material.) 2.
How long has it been since the stent was implanted? 3.
What type of MRI machine is being used?
Furthermore, since MRI machines operate with a strong magnetic field, I am concerned about whether the metallic components of the stent could pose risks due to induced currents or if the magnetic field could cause displacement.
As a patient who is uncertain about what to do, if I cannot undergo an MRI, I must inform my family that I can only have the MRI scan done at Medical Center A.
Sincerely,
Mr.
Li

Mr. Li, 50~59 year old female. Ask Date: 2018/03/29

Dr. Wang Yifen reply Radiology

Hello Mr.
Li, regarding the explanation of Magnetic Resonance Imaging (MRI), here are the details: MRI is a specialized examination conducted in a strong magnetic field environment, and a thorough safety assessment of the patient prior to the MRI is essential.
Certain metals may shift position due to the magnetic field's attraction, potentially causing harm, or may result in thermal burns due to the thermoelectric currents induced by the magnetic field.
The vast majority of cardiac metal stents can undergo MRI examinations; however, to ensure that entering the MRI room will not pose any risks, it is important to refer to the instructions provided with the vascular stent medical device.
To ensure the safety of the patient during the MRI procedure, the examination facility will require relevant documentation.
It is advisable to consult the hospital that placed your cardiac stent for the instruction manual or the Chinese product insert for the medical device.
If the manual clearly states "MRI safe" or "no known hazards," providing this documentation to the MRI facility will alleviate your concerns.

Reply Date: 2018/03/29

More Info

Dear Mr. Li,
Thank you for your detailed inquiry regarding the safety of undergoing MRI scans after having coronary stents placed. This is indeed a complex situation, and I appreciate your thoroughness in seeking clarity on the matter.

To address your concerns, let's break down the key factors that influence whether a patient with coronary stents can safely undergo an MRI scan:
1. Material of the Stent: The composition of the stent is crucial in determining its compatibility with MRI. Most modern coronary stents are made from non-ferromagnetic materials, such as cobalt-chromium or stainless steel, which are generally considered safe for MRI. However, older stents or those made from ferromagnetic materials can pose risks, as they may be affected by the magnetic field, potentially leading to displacement or heating.

2. Time Since Stent Placement: The timing of the MRI after stent placement is also significant. Generally, it is recommended to wait at least 6-8 weeks after the placement of a stent before undergoing an MRI. This waiting period allows for the tissue around the stent to heal and reduces the risk of complications. Since you mentioned that your stents were placed in March, you should be well within the safe window for an MRI, assuming no complications have arisen.

3. Type of MRI Machine: The strength of the MRI machine (measured in Tesla, T) is another important factor. Most clinical MRI machines operate at 1.5T or 3T. While many modern stents are compatible with these machines, it is essential to confirm with the specific MRI facility regarding their protocols and the compatibility of the stent with their equipment.

4. Potential Risks: The primary risks associated with MRI in patients with stents include the potential for movement of the stent due to the magnetic field, heating of the metal, and interference with the imaging quality. However, with modern stents and proper protocols, these risks are significantly minimized.
5. Communication with Healthcare Providers: It is crucial to maintain open communication with both your cardiologist and the MRI facility. Since your cardiologist has indicated that your stents are made from cobalt-nickel alloy and are compatible with MRI after 8 weeks, this is a positive sign. However, obtaining a written confirmation or clearance from your cardiologist may be beneficial for the MRI facility to alleviate any concerns they may have regarding liability.

In conclusion, based on the information provided, it appears that you should be able to undergo an MRI scan safely, given that your stents are made from appropriate materials and sufficient time has passed since their placement. However, it is essential to follow up with your healthcare providers to ensure that all necessary precautions are taken and that you have the required documentation for the MRI facility.

If you have any further questions or concerns, please do not hesitate to reach out to your healthcare team. Your health and safety are of utmost importance, and they will be able to provide you with the most accurate and personalized advice.

Best regards,
Doctor Q&A Teams

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