The Incidence of Venous Thrombosis Following Long-Term Transvenous Pacing

Transvenous Pacing Lead-Induced Thrombosis: A Series of Cases with a Review of the Literature

“…Much of this variation can be explained on the basis of differences in definition. Subclinical, silent venous thrombosis is surprisingly common occurring in up to 30% of all implants [17, 18, 19], which is similar to the reported incidence of silent pulmonary emboli [3]. Subanalysis of these venographic studies suggests that symptomatic venous obstruction affects as few as 0.5% of all implants [18], which concords with the 1–3% incidence reported by other investigators [19, 20, 21, 22, 23].…”

“…Subclinical, silent venous thrombosis is surprisingly common occurring in up to 30% of all implants [17, 18, 19], which is similar to the reported incidence of silent pulmonary emboli [3]. Subanalysis of these venographic studies suggests that symptomatic venous obstruction affects as few as 0.5% of all implants [18], which concords with the 1–3% incidence reported by other investigators [19, 20, 21, 22, 23]. The rarity of symptomatic thrombosis presumably reflects the fact that venous thrombosis occurs slowly in the vast majority of patients allowing the development of venous collaterals [19].…”

“…Nevertheless the incidence of serious thrombotic and embolic complications ranges between 0.6 and 3.5% [1, 2, 3, 4, 5]. Milder symptoms, such as facial and arm swelling ipsilateral to the pacemaker implant, occur slightly more frequently affecting 5% of all cases [6]. Clinically silent pacing lead-associated thrombosis is surprisingly very common occurring in as many as 35–45% of all implants undergoing venography 1 year postimplantation [1, 7].…”

Subclavian Vein Stenosis/Occlusion Following Transvenous Cardiac Pacemaker and Defibrillator Implantation: Incidence, Pathophysiology and Current Management

“…Even with more severe luminal narrowing (greater than 70%), most patients remain asymptomatic due to venous collateral formation. [4][5][6][7][8] Risk factors for subclavian vein stenosis have not been well elucidated. Various management strategies have been employed, including anticoagulation, lead extraction, percutaneous venoplasty with or without stenting, and surgical bypass.…”

Common Pacemaker Problems: Lead and Pocket Complications

“…Venous complications of pacemaker/ICD system implantation rarely cause immediate clinical problem. Only a few percent (1-3%) of patients with severe stenosis or occlusion of the deep veins of an upper extremity become symptomatic (Stoney et al, 1976;Crook et al, 1977). A few factors were proposed as predictors of severe venous stenosis/occlusion: a) presence of multiple pacemaker leads (compared to a single lead), b) use of hormone therapy, c) personal history of venous thrombosis, d) the presence of temporary wire before implantation, e) previous presence of a pacemaker (ICD as an upgrade) and f) the use of dual-coil leads.…”