title: Bioresorbable vascular scaffold to treat malignant in-stent restenosis in a patient with nickel allergy.
abstract: Nickel is the most frequent allergen in patients with allergic contact dermatitis and nickel allergy has been associated with recurrent in-stent restenosis. However, it is often misdiagnosed because of a low suspicion threshold. It should be discarded in patients with recurrent in-stent restenosis, especially if their medical history reveals prior contact dermatitis. It is also noteworthy and rarely specified that even newer generation stents that use novel metal alloys also contain low amounts of nickel. To avoid the implantation of new stents containing this metal, when percutaneous coronary intervention is indicated, drug eluting balloons or bioresorbable vascular scaffolds associated with small doses of steroids could provide good alternatives of treatment. To the best of our knowledge, this is the first description of this therapeutic alternative in such an exceedingly rare clinical scenario.
authors.affiliation: Interventional Cardiology Department, University General Hospital of Ciudad Real, Ciudad Real, Spain. Electronic address: alfonsojuradoroman@gmail.com.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Jurado-Román
authors.affiliation: Interventional Cardiology Department, University General Hospital of Ciudad Real, Ciudad Real, Spain.
authors.forename: María T
authors.initials: MT
authors.lastname: López-Lluva
authors.affiliation: Interventional Cardiology Department, University General Hospital of Ciudad Real, Ciudad Real, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Sánchez-Pérez
authors.affiliation: Interventional Cardiology Department, University General Hospital of Ciudad Real, Ciudad Real, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Piqueras-Flores
authors.affiliation: Interventional Cardiology Department, University General Hospital of Ciudad Real, Ciudad Real, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Maseda
authors.affiliation: Interventional Cardiology Department, University General Hospital of Ciudad Real, Ciudad Real, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Lozano-Ruíz-Poveda
mesh_terms: D020341:Absorbable Implants / Q000009:adverse effects; D017023:Coronary Angiography / Q000379:methods; D023903:Coronary Restenosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications* / Q000276:immunology; D008875:Middle Aged; D009532:Nickel / Q000276:immunology*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D009532:Nickel
keywords: Bioresorbable vascular scaffold; Nickel allergy; Restenosis