Successful treatment by balloon venoplasty and stent insertion of obstruction of the superior vena cava by an endocardial pacemaker lead.

Lindsay, H. S. J.; Chennells, P.M.; Perrins, E J

doi:10.1136/hrt.71.4.363

Cited by 38 publications

(28 citation statements)

References 7 publications

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“…Symptomatic venous occlusion is rare and generally presents as unilateral arm edema or superior vena cava syndrome (2,7). One large prospective series over ten years following 6256 patients with permanent pacemakers identified symptomatic venous hypertension in only 25 patients (0.4%) (8).…”

Section: Discussionmentioning

confidence: 99%

“…Venous obstruction at the access site may be silent and may be detected during re-implantation of a new lead due to lead failure, pacemaker upgrade or infection. The incidence of central venous obstruction is well documented but predictors of CVO are not clear (2).…”

Section: Introductionmentioning

confidence: 99%

“…These "late" complications include generator failure, lead failure, lead dislodgment, malfunction due to other mechanical factors, pericarditis, infection, skin erosion, hematoma, and venous thrombosis (1). Device-associated central venous obstruction (CVO) is rare but generally presents as unilateral arm edema (2). Treatment includes extremity elevation and anticoagulation.…”

Section: Introductionmentioning

confidence: 99%

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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%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Central venous obstruction and clinical predictors in patients with permanent pacemaker

Yeşìl¹,

Bayata²,

Arıkan³

et al. 2012

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

show abstract

“…However, as a palliative treatment, the authors found stent placement to be successful in 55% of the cases. (38) The rates of recurrence reported in the literature range from 0% to 45%. (36) The recurrence of the obstruction of the superior vena cava, secondary to the growth of the tumor in the interstices or along the stent borders and resulting in thrombosis, can be related to various factors.…”

Section: Clinical Resultsmentioning

confidence: 99%

“…(32,39) In one study, it was reported that five SVCS patients treated with stent placement developed recurrence of the syndrome. (38) All five patients were submitted to re-treatment with thrombolysis or placement of an additional stent and remained asymptomatic up until their death.…”

Section: Clinical Resultsmentioning

confidence: 99%

Tratamento da síndrome da veia cava superior

et al. 2005

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The superior vena cava is formed by the union of the right and left brachiocephalic veins. It is located in the middle mediastinum, to the right of the aorta and anterior to the trachea. Superior vena cava syndrome consists of a group of signs (dilation of the veins in the neck, facial swelling, edema of the upper limbs, and cyanosis) and symptoms (headache, dyspnea, cough, orthopnea and dysphagia) caused by the obstruction of blood flow through the superior vena cava to the right atrium. This obstruction can be caused by extrinsic compression, tumor invasion or thrombosis. Such obstruction may also occur as a result of insufficient venous return secondary to intra-atrial or intraluminal diseases. From 73% to 93% of all cases of superior vena cava syndrome occur during the development of an intrathoracic tumor. Most patients presenting superior vena cava syndrome secondary to malignant neoplasms are treated without surgery, through radiotherapy, chemotherapy or the use of intraluminal stents. When the etiology of superior vena cava syndrome is benign, it can be treated with clinical measures (anticoagulation, raising the head, etc.) or, in refractory cases, with angioplasty, stents or surgery.

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Morphological observation by intravascular ultrasound in superior vena cava syndrome after pacemaker implantation

Kitamura

Murakami

Shimada

et al. 1996

Cathet. Cardiovasc. Diagn.

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Successful treatment by balloon venoplasty and stent insertion of obstruction of the superior vena cava by an endocardial pacemaker lead.

Abstract: A 63 year old man with symptomatic obstruction of the superior vena cava associated with an indwelling pacemaker was successfully treated with balloon venoplasty and stent insertion. He was symptom free with normal pacemaker function nine months later.

Cited by 38 publications

References 7 publications

Central venous obstruction and clinical predictors in patients with permanent pacemaker

Central venous obstruction and clinical predictors in patients with permanent pacemaker

Tratamento da síndrome da veia cava superior

Morphological observation by intravascular ultrasound in superior vena cava syndrome after pacemaker implantation

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