Document Detail


Nickel allergy in interatrial shunt device-based closure patients.
MedLine Citation:
PMID:  18377434     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The possibility of nickel toxicity has been raised with interatrial shunt closure devices constructed of nitinol. This study is aimed to assess the potential adverse symptoms in terms of incidence, duration, and significance, in patients with interatrial shunt and nickel allergy who underwent nitinol device-based closure.
METHODS: We prospectively enrolled 46 consecutive patients (mean age 35 +/- 28.8 years, 30 female) over a 12-month period referred to our center for catheter-based closure of interatrial shunts. Patients were investigated for previous hypersensivity to nickel and were required to test potential nickel allergy with cutaneous patch test (TRUE test) before device implantation. Routinely, clinical visit with laboratory examinations, and TTE were scheduled at 1, 6, and 12 months.
RESULTS: Nine patients (19.5%, mean age 31.3 +/- 13.2 years) had proved symptomatic and instrumental nickel allergy as showed by cutaneous patch skin test but preferred to be implanted. All patients underwent successful transcatheter closure with an immediate occlusion rate of 100% without intraoperative complications. Between the 2nd and 3rd postoperative day, 8 out of 9 patients developed a sort of 'device syndrome' that included concurrent chest discomfort, exertional dyspnea and asthenia, and mild leukocytosis. The syndrome was treated with Prednison and Clopidogrel and in all was resolved after 1-week therapy. Interestingly, none of the patients without nickel allergy developed postclosure symptoms (P < .001).
CONCLUSIONS: In conclusion, nickel allergy is still a problematic issue in patients scheduled for transcatheter closure of intracardiac shunts; however, our brief study suggests that nickel allergy is not per se a contraindication to nitinol device closure.
Authors:
Gianluca Rigatelli; Paolo Cardaioli; Massimo Giordan; Silvio Aggio; Mauro Chinaglia; Gabriele Braggion; Loris Roncon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Congenital heart disease     Volume:  2     ISSN:  1747-0803     ISO Abbreviation:  Congenit Heart Dis     Publication Date:    2007 Nov-Dec
Date Detail:
Created Date:  2008-04-01     Completed Date:  2008-06-04     Revised Date:  2011-05-05    
Medline Journal Info:
Nlm Unique ID:  101256510     Medline TA:  Congenit Heart Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  416-20     Citation Subset:  IM    
Affiliation:
Rovigo General Hospital, Cardiovascular Diagnosis and Endoluminal Interventions Service, Rovigo, Italy. jackyheart@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Alloys / adverse effects*
Blood Vessel Prosthesis Implantation / adverse effects*,  instrumentation*
Female
Humans
Hypersensitivity, Immediate / diagnosis,  epidemiology,  etiology*
Male
Middle Aged
Nickel / immunology*
Prospective Studies
Skin Tests
Stents / adverse effects*
Time Factors
Chemical
Reg. No./Substance:
0/Alloys; 52013-44-2/nitinol; 7440-02-0/Nickel

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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