Norgaz Tugrul, Hobikoglu Gultekin, Serdar Zehra Asiran, Aksu Huseyin, Alper Ahmet Taha, Ozer Orhan, Narin Ahmet
Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department of Cardiology, Istanbul, Turkey.
Tohoku J Exp Med. 2005 Jul;206(3):243-6. doi: 10.1620/tjem.206.243.
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.
尽管许多冠心病患者正在接受冠状动脉支架治疗，但支架内再狭窄是经皮冠状动脉支架置入术的主要局限性。大多数支架由不锈钢制成，因此，对冠状动脉不锈钢支架释放的镍离子产生过敏反应可能是支架内再狭窄的触发机制之一。我们旨在通过一项前瞻性研究评估支架内再狭窄与镍过敏之间的关系。为此，我们在43例因稳定型心绞痛接受择期冠状动脉内支架置入术的患者术后当天对其进行镍斑贴试验，以评估镍过敏情况。在6个月时进行对照血管造影以确定支架内再狭窄情况。3例（6.9%）患者对镍有过敏反应，16例（37%）患者发生了支架内再狭窄。3例镍过敏患者中有1例出现弥漫性支架内再狭窄，其他患者未出现。因此，本研究不支持镍过敏与不锈钢支架置入患者支架内再狭窄发生之间的拟议关系。需要进行大规模研究才能得出最终结论。
