Hypersensitivity reactions associated with endovascular devices

Honari, Golara; Ellis, Stephen G.; Wilkoff, Bruce L.; Aronica, Mark A.; Svensson, Lars G.; Taylor, James S.

doi:10.1111/j.1600-0536.2008.01351.x

Cited by 120 publications

(118 citation statements)

References 78 publications

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“…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. Honari et al [105] reached the same conclusion after an extensive review of the literature in 2008, namely, that studies performed until then often involve a limited number of patients and known risk factors (eg, stent length, reference diameter, patient characteristics including diabetes, and smoking) may confound the results. However, a recent meta-analysis of 9 studies by Gong et al [110] in 2013 (total of 1223 patients) arrived at the opposite conclusion, namely, having a pre-existing metal allergy increases the risk of ISR, with an odds ratio of 2.65.…”

Section: Intravascular Devicesmentioning

confidence: 72%

“…With regards to DES in particular, Honari et al [105] noted that the existing data "suggest spectrums of hypersensitivity responses to DES," which include excessive inflammation, stent malposition, aneurysm formation, and late in-stent thrombosis. It is worth noting that hypersensitivity reactions to DES may be driven by factors other than the metal components, ie, the polymer.…”

Section: Intravascular Devicesmentioning

confidence: 99%

“…Bare metal stents are often made with several alloys, including stainless steel, and metallic ions are most likely the potential allergens in coronary stents [105]. DES may also contain alloys such as stainless steel and cobalt-chromium, but other allergens include the polymer coating the stent.…”

Section: Intravascular Devicesmentioning

confidence: 99%

“…Pacemakers are frequently made of titanium because of its biocompatibility, but they also contain other metals such as nickel and silicone [105]. Implantable cardioverter defibrillators (ICDs) were introduced in the 1980s and approved by the United States Food and Drug Administration (FDA) in 1985 [105].…”

Section: Intravascular Devicesmentioning

confidence: 99%

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Hypersensitivity Reactions to Implanted Metal Devices: Facts and Fictions

2016

J Investig Allergol Clin Immunol

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The use of metals in the medical field has become increasingly prevalent over the past few decades. Patients find themselves being exposed to metals in a variety of ways, ranging from external exposure to instruments such as the stainless steel in surgical blades to internal exposure via medical devices being implanted in their bodies. There has been growing interest in the possibility of developing hypersensitivity reactions to constituent metals in medical implant devices, both in cutaneous and systemic forms. Hypersensitivity reactions to metals are uncommon, but they are reported and require appropriate evaluation and management, particularly if they are symptomatic. In view of the lack of consensus in the field on the appropriate steps to evaluate and manage patients with suspected metal hypersensitivity reactions, this review aims to analyze current evidence on hypersensitivity reactions to metallic implants in orthopedic surgery, endovascular surgery, obstetrics and gynecology, and dental surgery. Key words: Metal hypersensitivity. Metallic implants. ResumenEl empleo de metales dentro de la medicina ha ido aumentando de forma progresiva en las últimas décadas. Los pacientes se exponen a metales de diferentes formas desde fuentes externas, como instrumental quirúrgico como el presente en las hojas de acero de los bisturíes, hasta implantes metálicos. Como consecuencia de ello se está produciendo un interés creciente por la posibilidad de desarrollar reacciones de hipersensibilidad a metales presentes en los materiales y objetos implantados, tanto en forma de reacciones cutáneas como sistémicas. Las reacciones de hipersensibilidad a metales no son frecuentes, pero pueden desarrollarse, y por ello, requieren de un diagnóstico y tratamiento adecuado, especialmente en aquellos pacientes que desarrollen síntomas. No existe un consenso en el proceso diagnóstico ni en el tratamiento de estas reacciones en los pacientes con sospecha de alergia a metales. Esta revisión tiene por objeto actualizar la evidencia existente sobre las reacciones de hipersensibilidad a implantes metálicos en cirugía ortopédica, cirugía endovascular, cirugía obstétrica y ginecológica (OB-GYN) así como la dental. Palabras clave: Hipersensibilidad a metales. Implantes metálicos.

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Section: Intravascular Devicesmentioning

confidence: 72%

Section: Intravascular Devicesmentioning

confidence: 99%

Section: Intravascular Devicesmentioning

confidence: 99%

Section: Intravascular Devicesmentioning

confidence: 99%

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Hypersensitivity Reactions to Implanted Metal Devices: Facts and Fictions

2016

J Investig Allergol Clin Immunol

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“…In individuals with Ni hypersensitivity, systemic allergic reactions to NiTi-based devices can cause inflammation near the implant and eventual device failure [3]. Biocompatibility concerns thus drive the development of low-Ni and Ni-free alternatives to conventional NiTibase SMAs.…”

Section: Introduction Motivation and Backgroundmentioning

confidence: 99%

Design of Heusler Precipitation Strengthened NiTi- and PdTi-Base SMAs for Cyclic Performance

Frankel

Olson

2015

Shap. Mem. Superelasticity

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For a wide range of actuation applications, the performance of NiTi-based shape memory alloys is limited by cyclic instability associated with accommodation slip. For medical applications, low-Ni compositions are also desirable. Increasing yield strength via precipitation of a coherent nanoscale Ni 2 TiAl-type Heusler phase from a supersaturated B2 matrix is an effective approach for eliminating slip in order to improve the stability of the functional response and increase the structural fatigue life. Quaternary additions that partition into the L2 1 Heusler phase, such as Zr or Pd, are favorable for reducing interphase misfit and maintaining coherency during aging. Phase relations and precipitation kinetics in quaternary Ni(TiZrAl), low-Ni (PdNi)(TiAl), and Ni-free (PdFe)(TiAl) systems are summarized from TEM and atom probe tomography data in the literature. Strengthening behavior during isothermal aging is compared in the NiTiZrAl and PdNiTiAl systems, and recent work characterizing a high-strength, low-Ni ''Hybrid'' (PdNi)(TiZrAl) alloy is presented. A systems design approach is taken in which an optimal microstructure for peak strengthening is identified while other property objectives such as transformation temperature, misfit, radiopacity, and biocompatibility are satisfied.

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Frequency of Contact Allergy to Implanted Cardiac Devices

et al. 2019

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and psychiatrists should be involved in the early stages of treatment. The limitation of our study is that we could not measure the actual disease duration between psoriasis and the mental health disorders. However, our study was strengthened by the use of standardized, large-population data to identify an association between psoriasis and mental health disorders. The present results demonstrate that psoriasis is associated with a higher risk for developing mental health disorders; therefore, dermatologists should play a role in detecting mental health disorders in patients with psoriasis, and in assembling a multidisciplinary team of medical professionals to treat these patients.

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Hypersensitivity reactions associated with endovascular devices

Cited by 120 publications

References 78 publications

Hypersensitivity Reactions to Implanted Metal Devices: Facts and Fictions

Hypersensitivity Reactions to Implanted Metal Devices: Facts and Fictions

Design of Heusler Precipitation Strengthened NiTi- and PdTi-Base SMAs for Cyclic Performance

Frequency of Contact Allergy to Implanted Cardiac Devices

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