Progression of venous pathology after pacemaker and cardioverter-defibrillator implantation: A prospective serial venographic study

Korkeila, Petri; Ylitalo, Antti; Koı̈stinen, Juhani; Airaksinen, Juhani

doi:10.1080/07853890802498961

Cited by 19 publications

(16 citation statements)

References 11 publications

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“…No patient had clinical signs or symptoms of venous obstruction. Another study delineated central venous anatomy prior to pacemaker implantation in 150 patients (11). Baseline venous obstruction or anomalies were found in 7% of patients.…”

Section: Discussionmentioning

confidence: 99%

Central venous obstruction and clinical predictors in patients with permanent pacemaker

Yeşìl¹,

Bayata²,

Arıkan³

et al. 2012

Anadolu Kardiyol Derg

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Objective: This study investigated the proportion of silent venous obstruction in patients who underwent pacemaker or lead reimplantation for various reasons. We also investigated independent predictors or risk factor of venous obstruction in this patient population. Methods: Seventy-three patients who underwent pacemaker pulse generator and/or lead reimplantation in our institution between 2007 and 2010 were enrolled for this retrospective case-control study. Prior to procedure, patients underwent ipsilateral venography. Patients' venographies were classified as non-significant obstruction (stenosis ≤70%, including normal venogram), significant obstruction (stenosis >70%) and complete obstruction. Continuous and categorical data were compared with Mann-Whitney U test and Chi-square statistics respectively. Logistic regression analysis was used to identify independent predictors of venous obstruction. Results: Complete or significant silent central venous obstruction (CVO) proportion was detected as 9.5% (n=7). Basal characteristics of patients with or without CVO were comparable. Significantly increased pacemaker pocket erosion incidence (57% vs 0%, p=0.001, in groups with and without CVO respectively) and significantly higher mean pacemaker age (15.3±10.2 years vs 10.4±5.1 years, p=0.047, in groups with and without CVO respectively) were found in group with CVO. Pacemaker pocket erosion (OR 3.00; 95% CI 1.024-9.302; p=0.001), higher pacemaker age (OR 1.33; 95% CI 1.026-1.733; p=0.02) were found as independent CVO predictors in multiple logistic regression analysis. Correlation analysis also revealed a significant correlation between previous or current pacemaker pocket erosion and CVO (r=0.80, p=0.001). Conclusion: Ipsilateral venography is a useful procedure prior to pacemaker or lead reimplantation to detect CVO. In addition to the increased pacemaker age, current or past history of erosion and infection at pacemaker pocket are probable clinical conditions related to CVO. These clinical conditions create a predisposition to CVO with unknown mechanisms, according to the results of this preliminary study. (

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Section: Discussionmentioning

confidence: 99%

Central venous obstruction and clinical predictors in patients with permanent pacemaker

Yeşìl¹,

Bayata²,

Arıkan³

et al. 2012

Anadolu Kardiyol Derg

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“…56 Several clinical studies have similarly demonstrated the common occurrence of venous stenoses and occlusion after endovascular pacing and defibrillator lead placement; however, the venous pathology is frequently asymptomatic. [57][58][59] Similarly, asymptomatic venous thrombosis is commonly observed in patients with abandoned leads, again with little clinical significance. 27,34,47,49 In contrast, little is known about the effects of lead extraction on venous patency, and attempts to study this have been confounded by ipsilateral reimplantation, making it impossible to isolate the effects of extraction.…”

Section: Preserving Venous Accessmentioning

confidence: 99%

Lead Extraction Is Preferred for Lead Revisions and System Upgrades: When Less Is More

Maytin

Epstein

Henrikson³

2010

Circ: Arrhythmia and Electrophysiology

106

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“…Transvenous pacing leads generate a continuous reaction between the lead insulation material, the endothelium of the vessel walls and the coagulation system. These processes lead to adhesions of the lead to the veins, and may produce stenosis and occlusion with consequences affecting lead management [9–11]. Although there is an on‐going discussion in literature on the advantages of transvenous versus epicardial leads, the favored procedure mostly reflect each center's specialization [12, 13].…”

Section: Discussionmentioning

confidence: 99%

Vascular interventions in young patients undergoing transvenous pacemaker revision

Zartner

Toussaint-Goetz

Wiebe

et al. 2011

Cathet Cardio Intervent

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Progression of venous pathology after pacemaker and cardioverter-defibrillator implantation: A prospective serial venographic study

Abstract: TVO is not uncommon after pacemaker implantation, and mostly occurs without any localizing symptoms. Most venous lesions seem to develop during the first months postimplantation, but late and unpredictable TVO may also occur.

Cited by 19 publications

References 11 publications

Central venous obstruction and clinical predictors in patients with permanent pacemaker

Central venous obstruction and clinical predictors in patients with permanent pacemaker

Lead Extraction Is Preferred for Lead Revisions and System Upgrades: When Less Is More

Vascular interventions in young patients undergoing transvenous pacemaker revision

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