• World Neurosurg · Dec 2018

    Case Reports

    Use of Pipeline Endovascular Device in Patients with Nickel Allergies.

    • Daniel A Tonetti, Jennifer L Perez, Alp Ozpinar, Benjamin Zussman, Bradley A Gross, and Brian T Jankowitz.
    • Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. Electronic address: tonettida@upmc.edu.
    • World Neurosurg. 2018 Dec 1; 120: 349-351.

    BackgroundMetal 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.Case DescriptionWe 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.ConclusionsIn 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.Copyright © 2018 Elsevier Inc. All rights reserved.

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