Tonetti Daniel A, Perez Jennifer L, Ozpinar Alp, Zussman Benjamin, Gross Bradley A, Jankowitz Brian T
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA; University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
World Neurosurg. 2018 Dec;120:349-351. doi: 10.1016/j.wneu.2018.09.041. Epub 2018 Sep 18.
Metal allergies affect a significant portion of the population; intracranial flow diverters contain many of the most commonly allergenic metals. Prior literature has suggested patch testing for all patients with documented or suspected metal allergies before intracranial flow diverter placement; however, there remains a paucity of reports of patients with documented metal allergies undergoing intracranial flow diversion.
We report 2 patients with documented nickel allergies, confirmed via patch testing by a board-certified allergist, and unruptured intracranial aneurysms that underwent treatment with the PED. Both patients developed contact dermatitis when a PED was affixed to their skin during their preoperative workup. Follow-up arteriography at 12 and 36 months post PED placement showed no evidence of in-stent stenosis or intimal hyperplasia, and both patients never developed systemic allergic reactions.
In 2 patients with known nickel allergies and intracranial aneurysms treated with the PED, there were no clinically or radiographically apparent allergic reactions at greater than 2 years of follow-up.
金属过敏影响着相当一部分人群；颅内血流分流器包含许多最常见的致敏金属。既往文献建议，在植入颅内血流分流器之前，对所有有记录或疑似金属过敏的患者进行斑贴试验；然而，关于有记录的金属过敏患者接受颅内血流分流术的报道仍然很少。
我们报告了2例经董事会认证的过敏症专科医生通过斑贴试验确诊为镍过敏的患者，他们患有未破裂的颅内动脉瘤，并接受了PED治疗。在术前检查期间，当PED贴在他们皮肤上时，两名患者均出现了接触性皮炎。PED植入后12个月和36个月的随访血管造影显示，没有支架内狭窄或内膜增生的迹象，且两名患者均未出现全身过敏反应。
在2例已知镍过敏且接受PED治疗的颅内动脉瘤患者中，随访超过2年未出现临床或影像学上明显的过敏反应。
