Treatment of Pacemaker-Induced Superior Vena Cava Syndrome by Balloon Angioplasty and Stenting

Klop, Boudewijn; Scheffer, M; McFadden, Eugène; Bracke, Frank; Gelder, Berry van

doi:10.1007/s12471-010-0052-6

Cited by 21 publications

(15 citation statements)

References 17 publications

(22 reference statements)

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“…In case of pacemaker leads associated SVC syndrome, stent placement and balloon venoplasty are viable options. The limitation of traditional balloon venoplasty is a high recurrence rate [9]. Our institution has had limited but favorable outcomes with the use of Drug Coated Balloon (DCB) therapy in juxtacardiac lesions such as recurrent pulmonary venous stenosis [10].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Management of Non Malignant Superior Vena Cava Syndrome Using IN.PACT Paclitaxel Coated Balloon

Iftikhar¹,

Gajo²,

Fisher³

et al. 2017

AJCTS

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Superior Vena Cava (SVC) syndrome is an uncommon but known complication of Implantable Cardioverter Defibrillator (ICD) and pacemaker lead placement. In general 0.2 to 3% of all implants are associated with symptomatic SVC stenosis. Stent placement is a viable option for benign SVC syndrome in the absence of indwelling pacing leads. The risk of perforation and lead fracture increases when large numbers of leads are present chronically. We describe here a case of patient with SVC syndrome secondary to chronic ICD and pacemaker lead placement and a novel use of IN.PACT tm paclitaxel drug coated balloon to treat the SVC obstruction with a favorable clinical result.

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Section: Discussionmentioning

confidence: 99%

Percutaneous Management of Non Malignant Superior Vena Cava Syndrome Using IN.PACT Paclitaxel Coated Balloon

Iftikhar¹,

Gajo²,

Fisher³

et al. 2017

AJCTS

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“…2 Superior vena cava syndrome secondary to pacemaker lead placement is characteristic of patients in whom there is concern about the compromise (and functioning) of pacemaker leads when those leads are adversely affected by stent placement. 3,4 Currently, only a few case reports describe the use of uncovered stents as a treatment option. 3,5 The theory is that the pacemaker wires will be incorporated into the venous wall, thereby obviating any contact with the stent or balloon.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Treatment of Superior Vena Cava Syndrome via Balloon-in-Balloon Catheter Technique with a Palmaz Stent

Shatila¹,

Almanfi²,

Massumi³

et al. 2016

Texas Heart Institute Journal

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S uperior vena cava (SVC) syndrome is a well-known disease entity that carries substantial rates of morbidity and mortality. Although most cases of SVC syndrome are secondary to a malignant process, 1 benign causes, such as pacemaker lead implantation, have been reported. 2 We present a case of SVC syndrome in a young woman after pacemaker implantation, whom we treated with venoplasty and stenting, aided by a balloon-in-balloon (BIB) catheter system. Case ReportA 30-year-old woman with a known history of SVC stenosis presented to us for further evaluation and management of positional syncope. The patient had a history of sick sinus syndrome and of multiple radiofrequency ablations of the sinus node-hence the eventual need for a dual-chamber permanent pacemaker. She eventually underwent multiple revisions for lead malfunction and generator-site infection. She was next diagnosed, by means of computed tomography (CT), with SVC obstruction, after which she had a 5-cm saphenous vein bypass graft implanted from the right brachiocephalic vein to the right atrial appendage, through which the pacemaker leads were rerouted.When the patient presented to us, she reported chronic fatigue, shortness of breath, and palpitations that had progressively worsened. She also reported facial and neck swelling that was worse in the morning, along with positional syncope that occurred whenever she bent forward. On physical examination, she had slightly distended jugular veins, with only minor bilateral arm swelling at rest-and positional syncope was reproduced. Results of repeat chest CT scanning with contrast medium were consistent with SVC obstruction, as was near-occlusion of her SVC bypass graft. Venography then confirmed that the pacemaker leads were in an occluded saphenous vein graft and that she had longstanding SVC stenosis, with a large azygos vein "pop-off" to the inferior vena cava. There was no gradient across the SVC stenosis, given that the azygos vein was offloading flow from the SVC into the inferior vena cava. Both brachiocephalic veins were patent (Fig. 1). The native SVC was estimated to be 18 mm in diameter.At a later date, we proceeded with angioplasty and stent implantation at the SVC stenosis. Access was attained through the right common femoral vein with use of an 8F sheath. Heparin was used as an anticoagulant to maintain an activated clotting time of >200 s. An intravascular ultrasound catheter (Volcano Corporation; San Diego, Calif ) was advanced through the right common femoral vein for imaging of

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“…These preliminary studies reported excellent acute efficacy and short‐ and midterm primary patency rates (up to 30 months) . The reported complications included a lead fracture and remnant associated with lead extraction and later stent dislocation and occlusion associated with stent deployment . The extraction site with venous access maintained could be used for access for the balloon and stent .…”

Section: Discussionmentioning

confidence: 99%

Outcome and Management of Pacemaker‐Induced Superior Vena Cava Syndrome

Huang

Zhong

et al. 2014

Pacing Clinical Electrophis

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Treatment of Pacemaker-Induced Superior Vena Cava Syndrome by Balloon Angioplasty and Stenting

Cited by 21 publications

References 17 publications

Percutaneous Management of Non Malignant Superior Vena Cava Syndrome Using IN.PACT Paclitaxel Coated Balloon

Percutaneous Management of Non Malignant Superior Vena Cava Syndrome Using IN.PACT Paclitaxel Coated Balloon

Endovascular Treatment of Superior Vena Cava Syndrome via Balloon-in-Balloon Catheter Technique with a Palmaz Stent

Outcome and Management of Pacemaker‐Induced Superior Vena Cava Syndrome

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