Which stents are feasible for MR?

  I. Coronary and Peripheral Stents The AHA statement clearly states that almost all commercially available coronary stent products, have been tested and have been indicated as MR safe. Whereas early peripheral artery stents (prior to 2007) may be weakly magnetic, other than that, all stent products are safe on MRI at ≤3T, and some investigators have confirmed that MR can be performed on the same day of stent implantation. For those peripheral arterial stents that are if magnetic, safety considerations are necessary, but magnetic field exposure after 6 weeks is generally considered to be unproblematic.  Therefore, both bare metal stents and drug-coated stents are MR safe.  Mechanical Valves According to the 2007 AHA statement, almost all prosthetic heart valves and rings on the market are MR safe and can be MRI’d at ≤3T at any given time.  In addition, the “wire” that holds the sternum in place has also been shown to be MR safe, although there may be local thermal effects due to regional variability in materials.  Therefore, mechanical flaps are also safe.  Most of the suturing and blocking devices are MR safe. The instructions will indicate whether they have been tested or not.  The majority of IVC filters are MR safe, but for a few magnetic devices, such as Cook’s Gianturco bird nest or Boston Scientific’s Greenfield filter, the guidelines recommend a 6-week interval before MR testing.  V. Floating catheters Patients with Swan-Ganz catheters should not undergo MRI. Although in vivo testing has confirmed that MR images can be obtained safely, there are still possible risks associated with catheters, guidewires, etc., and MRI is not recommended.  VI. Temporary Pacemakers Temporary pacing leads retained in the epicardium are MR safe. However, both extracorporeal pacing with adhesive electrodes and transvenous temporary pacing are not recommended for MRI.  VII. Pacemakers and ICDs The greatest risk of MR examinations with this class of devices lies in the possible displacement of the device, changes in the procedure, effects on the work of the pacemaker itself, or thermal effects produced by the electrodes.  However, we are guided by the fact that there are manufacturers who have made many efforts for this purpose, and MR-compatible pacemakers have been introduced into the clinic as early as now. But even so, MRI should be more cautious in this category of patients who have MR-compatible pacemakers implanted.  VIII. IABP Although no one has conducted a systematic safety evaluation of it, the 2007 statement clearly pointed out that IABP is an absolute contraindication to MR.