Imperial College London
Alternate

Professor Alun H Davies, MA,DM,DSc,FRCS,FHEA,FEBVS,FACPh

Faculty of Medicine, Department of Surgery & Cancer

Professor of Vascular Surgery
 
 
 
//

Contact

 

+44 (0)20 3311 7309a.h.davies

 
 
//

Location

 

4E04 EastEast WingCharing Cross Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Gueroult:2022:10.1136/heartjnl-2021-319940,
author = {Gueroult, A and Al-Balah, A and Shalhoub, J and Davies, A},
doi = {10.1136/heartjnl-2021-319940},
journal = {Heart},
pages = {1707--1715},
title = {Nickel hypersensitivity and endovascular devices: a systematic review and meta-analysis},
url = {http://dx.doi.org/10.1136/heartjnl-2021-319940},
volume = {108},
year = {2022}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objective Nickel allergy is common; endovascular specialists are often confronted with nickel allergic patients ahead of the implantation of endovascular devices, many of which are nickel-containing. Our aim was to elucidate whether nickel hypersensitivity is significantly associated with worse or adverse outcomes after placement of a nickel-containing endovascular device.Methods Inclusion criteria were: endovascular and transcatheter procedures for coronary, structural heart, neurovascular and peripheral vascular pathology involving nickel-allergic patients. All adverse outcomes were included as defined by included studies. A systematic review and meta-analysis were undertaken using a random-effects model. Searches of MEDLINE and EMBASE were conducted for articles published 1947–2019.Results 190 records were identified, 78 articles were included for qualitative synthesis and 15 met criteria for meta-analysis. Patch-test confirmed nickel allergy was associated with an increased risk of adverse outcomes following implantation of a nickel-containing endovascular device (n=14 articles, 1740 patients; OR 2.61, 95% CI 1.41 to 4.85). This finding further was observed in coronary (n=12 articles, 1624 patients; OR 1.94, 95% CI 1.16 to 3.23) and structural heart subgroups (n=2 articles, 83 patients; OR 52.28, 95% CI 1.31 to 2079.14), but not in the neurovascular subgroup (n=1 article, 33 patients; OR 3.04, 95% CI 0.59 to 15.72) or with a patient-reported history of nickel allergy (n=2 articles, 207 patients; OR 2.14, 95% CI 0.23 to 19.70).Conclusions Patch-tested nickel allergy is associated with an increased risk of adverse outcomes following endovascular device implantation and alternative treatment options should be considered. Specialists faced with patients’ self-reporting nickel allergy should consider proceeding to diagnostic patch-testing.
AU  - Gueroult,A
AU  - Al-Balah,A
AU  - Shalhoub,J
AU  - Davies,A
DO  - 10.1136/heartjnl-2021-319940
EP  - 1715
PY  - 2022///
SN  - 1355-6037
SP  - 1707
TI  - Nickel hypersensitivity and endovascular devices: a systematic review and meta-analysis
T2  - Heart
UR  - http://dx.doi.org/10.1136/heartjnl-2021-319940
UR  - https://heart.bmj.com/content/early/2021/10/26/heartjnl-2021-319940.info
UR  - http://hdl.handle.net/10044/1/92494
VL  - 108
ER  -
Download