Nickel allergy complicating iliac vein stent requiring explantation

Essentially all endovascular stents, both stainless steel and nitinol, contain a nickel component. Incidence of nickel hypersensitivity is common, but nickel hypersensitivity does not always result in clinically significant reactions. This 43-year-old woman presented with hives, urticaria, and malaise after nitinol stent placement in her left iliac vein for May-Thurner syndrome. She underwent open stent explanation and reconstruction of her inferior vena cava and left common iliac vein with subsequent resolution of symptoms. The low incidence of stent-related allergy does not warrant preoperative testing, but we advocate for thorough preprocedural discussion in high-risk patients. For symptomatic patients, explanation can be effective.