Venous Occlusion of the Access Vein in Patients Referred for Lead Extraction:
- 24 July 2003
- journal article
- website
- Published by Wiley in Pacing and Clinical Electrophysiology
- Vol. 26 (8), 1649-1652
- https://doi.org/10.1046/j.1460-9592.2003.t01-1-00247.x
Abstract
The aim of this study was to determine the effect of patient and lead characteristics on occlusion of the access vein in pacemaker and ICD patients. Contrast venography of the access vein was obtained in 89 patients (17 patients with an ICD) scheduled for lead extraction. The indication for extraction was infection in 57 patients (systemic infection in 9) and lead malfunction in 32 patients. In 6 of the 89 patients, leads were introduced in both the right and left subpectoral area, resulting in a total of 95 venous entry sites. In 22 of these entry sites one lead was present, in 61 two leads, in 11 three, and in 1 four leads. The vessel patency was graded open or occluded. Occlusion of the subclavian vein occurred in four (13%) patients with lead malfunction versus 18 (32%) patients with infection (P = 0.07). In patients with systemic infection, 5 of 9 showed venous occlusion (P = 0.01 when compared to patients with malfunction, odds ratio 8.75, 95% confidence interval 1.21–64.11). Considered per entry site, the incidence of occlusion was 7 of 22 with one lead present, 17 of 61 with two leads, 0 of 11 with three leads, and 0 of 1 with four leads (P = 0.13). No patient had a superior vena caval occlusion. Patients with systemic infection have an increased risk of occlusion of the access vein. On the contrary, the study found no support for the concept that the risk of venous occlusion increases with a higher number of leads present. (PACE 2003; 26:1649–1652)Keywords
This publication has 12 references indexed in Scilit:
- Prevalence of central venous occlusion in patients with chronic defibrillator leadsAmerican Heart Journal, 2001
- Diagnosis and Management of Infections Involving Implantable Electrophysiologic Cardiac DevicesAnnals of Internal Medicine, 2000
- Long‐Term Outcome of Patients with Multiple (≥ 3) Noninfected Transvenous Leads: A Clinical and Echocardiographic StudyPacing and Clinical Electrophysiology, 2000
- Assessment of the Subclavian Vein in Patients with Transvenous Pacemaker LeadsPacing and Clinical Electrophysiology, 1998
- Long‐Term Thrombosis after Transvenous Permanent Pacemaker ImplantationPacing and Clinical Electrophysiology, 1998
- Echographic Detection of Latent Severe Thrombotic Stenosis of the Superior Vena Cava and Innominate Vein in Patients with a Pacemaker: Integrated Diagnosis Using Sonography, Pulse Doppler, and Color FlowPacing and Clinical Electrophysiology, 1997
- Extraction of implanted transvenous pacing leads: A review of a persistent clinical problemAmerican Heart Journal, 1991
- Thrombotic complications with pacemakersInternational Journal of Cardiology, 1983
- Venous Obstruction in Permanent Pacemaker Patients: An Isotopic StudyPacing and Clinical Electrophysiology, 1981
- The Incidence of Venous Thrombosis Following Long-Term Transvenous PacingThe Annals of Thoracic Surgery, 1976