Is There a Link between Nickel Allergy and Coronary Stent Restenosis?

Abstract

NARIN, A. Is There a Link between Nickel Allergy and Coronary Stent Restenosis?Tohoku J. Exp. Med., 2005, 206 (3), [243][244][245][246] Although many patients with coronary artery disease are being treated by coronary stents, in-stent restenosis is the major limitation of percutaneous coronary stenting procedures. Most stents are made of stainless steel, and that, allergic reactions to nickel ions released from coronary stainless-steel stents may be one of the triggering mechanisms for in-stent restenosis. We aimed to evaluate the relationship between in-stent restenosis and nickel allergy in a prospective study. For this purpose, we applied epicutaneous patch test for nickel in 43 patients who had undergone elective intracoronary stent placement for stable angina pectoris in the day following stent placement and evaluated the presence of nickel allergy. Control angiography was performed at 6 months to determine in-stent restenosis. Three (6.9%) patients had allergic reaction to nickel and 16 (37%) patients had developed in-stent restenosis. One of the 3 patients with nickel allergy had diffuse in-stent restenosis and the others not. The present study therefore does not support the proposed relationship between nickel allergy and development of in-stent restenosis in patients having stainless steel stents. Large scale studies are needed to reach a final conclusion. coronary stenting; in-stent restenosis; metal allergy; nickel; patch test

The evolution of cardiovascular stent materials and surfaces in response to clinical drivers: A review

“…The debate focused on nickel due to it being present at higher levels than molybdenum in 316L -nominally 12% compared to 2.5%, respectively. While the subject did fuel ongoing developments of inorganic stent coatings, to prevent ion release, subsequent studies have failed to establish an effect [20]. It is also worth noting that the introduction of cobaltchromium alloy stents was not impeded by the discussion; L605 contains 10% nickel while MP35N contains 35% nickel and 10% molybdenum.…”

Stent implantation in patients with metal allergy

“…A third study was excluded as it was actually an article investigating whether patients with a stent implanted have a higher risk of developing contact allergy [9]. Finally, nine studies [5,6,[10][11][12][13][14][15][16], including 1223 patients, were included in the meta-analysis. Table 1 shows the characteristics of all nine studies included in our analysis.…”

Hypersensitivity Reactions to Implanted Metal Devices: Facts and Fictions

“…Hillen et al [107] and Norgaz et al [108] reached the conclusion that pre-existing metal allergy should not be considered a risk factor for developing ISR, although they acknowledged that the small number of patients limited the study. Thyssen et al [109] performed an individual linkage study of 149 patients and found that nickel and/or chromium allergy in dermatitis patients does not appear to increase the overall risk of ISR after percutaneous coronary intervention.…”