nitinol and Hypersensitivity

Nickel is used in many cerebral endovascular treatment devices. However, nickel hypersensitivity is the most common metal allergy, and the relative risk of treatment in these patients is unknown. This retrospective analysis identified patients with nickel or metal allergies who underwent cerebral endovascular treatment with nickel-containing devices. Seven patients with nickel and/or other metal allergies underwent treatment with 9 nickel-containing devices. None experienced periprocedural complications. No patient received treatment with corticosteroids or antihistamines. At a mean clinical follow-up for all patients of 22.8 months (range, 10.5-38.0 months), no patients had symptoms attributable to nickel allergic reactions. The mean radiographic follow-up for all patients at 18.4 months (range, 2.5-37.5 months) showed successful treatment of the targeted vascular pathologies, with no evidence of in-stent stenosis or other allergic or hypersensitivity sequelae. The treatment of cerebrovascular lesions with a nickel-containing device resulted in no adverse outcomes among these patients and was safe and effective.

Topics: Alloys; Cerebrovascular Disorders; Humans; Hypersensitivity; Nickel; Retrospective Studies

Presently described is transcatheter closure of atrial septal defect with atrial septal occluder (ASO) device in a patient with nickel allergy. Patients with metal allergy who will undergo nitinol device implantation should be tested for possible nickel hypersensitivity. ASO device and treatment strategy (percutaneous or surgical) should be selected according to allergy test result.

Topics: Adult; Alloys; Cardiac Catheterization; Female; Heart Septal Defects, Atrial; Humans; Hypersensitivity; Nickel; Patch Tests; Prosthesis Design; Septal Occluder Device

Topics: Alloys; Aortic Aneurysm; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Endovascular Procedures; Humans; Hypersensitivity; Inflammation; Polyesters; Prosthesis Design; Risk Factors; Stents; Syndrome; Treatment Outcome

Topics: Alloys; Angioplasty; Device Removal; Female; Femoral Artery; Humans; Hypersensitivity; Intermittent Claudication; Middle Aged; Peripheral Arterial Disease; Remission Induction; Stents; Treatment Outcome

Nickel hypersensitivity has been reported in up to 15% of the general population. However, there are few reported cases of patients developing nickel allergy after cardiac device implantation. This phenomenon is generally not well understood and many authorities believe that these devices are safe. Most reported cases of nickel allergy have presented with non-specific symptoms such as chest pain, palpitations, or pericarditis and the majority of patients have undergone atrial septal defect closure with devices containing nickel, such as the Amplatzer septal occluder device (St Jude Medical). Herein, we describe a case of hypersensitivity pericarditis complicated with cardiac tamponade that responded dramatically to anti-inflammatory therapy. We hypothesize that this hypersensitivity was secondary to nickel allergy.

Topics: Aged; Alloys; Anti-Inflammatory Agents; Cardiac Tamponade; Female; Heart Septal Defects, Atrial; Humans; Hypersensitivity; Nickel; Pericarditis; Septal Occluder Device; Treatment Outcome

A variety of nitinol-containing devices for transcatheter closure of atrial septal defects (ASD) has been widely used. However, there is concern about the release of nickel after nitinol device implantation. In this study, a platinum-coated nitinol device was braided from nanoplatinum-coated nitinol wires in order to prevent nickel release. The serum nickel levels before and after device implantation and the 1-year results were evaluated.. Thirty-one patients, aged 4-59 years, and weighing 13.7-90.0 kg, underwent transcatheter closure. Blood samples for serum nickel levels were taken before, 1 day, 1 week, 1 month and 3 months after implantation.. Twenty-nine (93.6%) patients had a successful implantation. The mean ASD diameter was 19.7 +/- 4.8 mm (range 10-30 mm). Procedure-related complications included transient brachial plexus injury in 1 patient and transient dysrhythmia in 4 patients. All 29 patients had complete closure within 1 month after implantation. The mean serum nickel levels at baseline and at 1 day, 1 week, 1 month and 3 months after implantation were 0.65 +/- 0.28, 0.63 +/- 0.18, 0.67 +/- 0.34, 0.55 +/- 0.16, 0.52 +/- 0.14 ng/ml, respectively. There was no significant difference in serum nickel levels before and after implantation. There were no device-related complications at 1-year follow up.. Transcatheter ASD closure using a platinum-coated nitinol device can be performed safely and successfully with good outcomes. Nano-coating of platinum on nitinol wires can prevent nickel release following device implantation.

Topics: Adolescent; Adult; Alloys; Cardiac Catheterization; Child; Child, Preschool; Female; Heart Septal Defects, Atrial; Humans; Hypersensitivity; Male; Middle Aged; Nickel; Platinum Compounds; Prospective Studies; Risk Factors

To determine the influence of chromium and nickel concentrations in saliva and their effects on gingival tissues during orthodontic treatment.. Twenty orthodontic patients (10 males and 10 females), 17 to 20 years of age, were treated with fixed orthodontic appliances in the maxillary arch. Using atomic absorption spectrophotometer, the concentration of both metals was recorded during pretreatment, at 3 and 12 months into treatment, and 1 month after debonding. The depth of gingival crevice was recorded as well.. After 3 months, 20% of females and 10% of males in this study showed allergic reaction in a form of gingivitis. This had disappeared by 1 month after appliance removal.. While allergy to either nickel or chromium is not a serious medical problem, oral hygiene measures in at-risk patients should be optimal, with use of fluoride-free toothpaste and mouthrinse.

Topics: Adolescent; Adult; Alloys; Chromium; Dental Alloys; Dental Debonding; Female; Follow-Up Studies; Gingiva; Gingivitis; Humans; Hypersensitivity; Longitudinal Studies; Male; Nickel; Orthodontic Appliances; Periodontal Index; Saliva; Spectrophotometry, Atomic; Stainless Steel

Topics: Adult; Alloys; Female; Heart Septal Defects, Atrial; Humans; Hypersensitivity; Prostheses and Implants; Skin Tests