Upper-Extremity Subintimal Arterial Flossing with Antegrade–Retrograde Intervention: Thumbs up

determine a systemic allergic reaction, as reported in the present patient. The present patient had an early reaction with generalized pruritus, rash, and leg edema, suggesting an immediate systemic reaction to nickel exposure. Although a transitory improvement of systemic reaction was observed after steroid therapy, the clinical conditions worsened, probably because of the continued exposure to nickel from the stents. Only complete removal of the segment of the SFA containing the stents resulted in a significant and immediate improvement of clinical symptoms, with complete resolution of leg edema after 1 month. In conclusion, the present report emphasizes the risk of a systemic reaction in the setting of a nickel allergy in patients undergoing placement of nitinol stents for the treatment of peripheral vascular disease. The clinical effect of nickel allergy on stent stenosis, although suggested for coronary artery stent placement, is unknown,