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Is there an association between flow diverter fish mouthing and delayed-type hypersensitivity to metals?-a
Naci Kocer1, Prabath Kumar Mondel2, Elif Yamac2
1Department of Radiology, Division of Neuroradiology, Cerrahpasa Medical Faculty, Istanbul University, Kocamustafapasa, 34098, Istanbul, Turkey. nkocer@istanbul.edu.tr.
Neuroradiology
|September 7, 2017
Summary
Flow diverter fish-mouthing in intracranial aneurysms was not linked to metal hypersensitivity. However, a history of allergy and smaller aneurysm size were associated with this complication, suggesting closer monitoring for at-risk patients.
Area of Science:
- Neurosurgery
- Interventional Neuroradiology
- Biomaterials Science
Background:
- Flow diverters are crucial for treating complex intracranial aneurysms.
- Late complications, such as aneurysmal rupture, can occur.
- Flow diverters may exhibit focal luminal diameter reduction, termed 'fish-mouthing', without intimal hyperplasia.
Purpose of the Study:
- To investigate the potential association between flow diverter fish-mouthing and delayed-type hypersensitivity to metal constituents.
- To identify factors predicting flow diverter fish-mouthing.
Main Methods:
- Retrospective review of nine patients with flow diverter fish-mouthing and 25 controls.
- Prospective patch testing for hypersensitivity to flow diverter metals.
- Logistic regression and Wilcoxon sign rank sum tests for statistical analysis.
Main Results:
- No statistically significant association was found between flow diverter fish-mouthing and positive patch tests.
- Multivariate analysis revealed a significant association between fish-mouthing and a history of allergy.
- Maximum aneurysm size was also associated with flow diverter fish-mouthing.
Conclusions:
- Flow diverter fish-mouthing is significantly associated with a history of contact allergy and smaller aneurysm size.
- Further large-scale studies are required to confirm the link with patch test results.
- Recommend increased surveillance for patients with contact allergies to monitor for fish-mouthing progression.
