|Prevalence of venous occlusion in patients referred for lead extraction: implications for tool selection|
|Li, Xuebin1,2; Ze, Feng2,3; Wang, Long2,3; Li, Ding2,3; Duan, Jiangbo2,3; Guo, Fei1; Yuan, Cuizhen2,3; Li, Yuguang1; Guo, Jihong2,3|
|关键词||Venous occlusion Infection Pacemaker leads Phlebography Lead extraction|
|WOS标题词||Science & Technology|
|类目[WOS]||Cardiac & Cardiovascular Systems|
|研究领域[WOS]||Cardiovascular System & Cardiology|
|关键词[WOS]||IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR ; PACEMAKER LEADS ; DEVICE UPGRADE ; ACCESS VEIN ; OBSTRUCTION ; THROMBOSIS ; INSERTION ; REVISION|
Aims Data concerning the incidence of venous obstruction in patients referred for lead extraction is limited. Thus, we aimed to assess the incidence of venous obstruction in patients referred for lead extraction and the implications for tool selection.
Methods and results Contrast venography of the access vein was obtained in 202 patients (147 men; mean age, 62.4 +/- 14.5 years) scheduled for lead extraction. The indication for lead extraction included infection (n = 145, 72%) and other causes (n = 57, 28%). Two patients with device infection had superior vena caval occlusion. Access vein occlusion occurred in 6(11%) patients without infection vs. 46 (32%) patients with infection [P = 0.002; odds ratio (OR) 3.94; 95% confidence interval (CI) 1.58-9.87]. No significant differences between occluded and non-occluded patients were seen for age, sex, device type, number of leads, time from implant of the initial lead, or anticoagulation therapy (all P > 0.05). Procedural duration and fluoroscopy exposure time were significantly lower in the open group than in the occluded group (P < 0.05). Patients with venous occlusion required more advanced tools for lead extraction, such as dilator sheaths, evolution sheaths, and needle′s eye snares (P = 0.019).
Conclusion Both systemic and local infections are associated with increased risk of access vein occlusion. We found no support for the hypothesis that venous occlusion increases with the number of leads present. Lead extraction was more difficult in patients with venous occlusion, requiring advanced tools and more time.
|资助机构||Beijing Science and Technology Commission|
|作者单位||1.Shantou Univ Med Coll, Affiliated Hosp 1, Dept Cardiol, Shantou City 515000, Guangdong, Peoples R China|
2.Peking Univ Peoples Hosp, Dept Cardiac Electrophysiol, Beijing 100044, Peoples R China
3.Minist Educ, Key Lab Mol Cardiovasc Sci, Dept Cardiol, Beijing 100044, Peoples R China
|Li, Xuebin,Ze, Feng,Wang, Long,et al. Prevalence of venous occlusion in patients referred for lead extraction: implications for tool selection[J]. EUROPACE,2014,16(12):1795-1799.|
|APA||Li, Xuebin.,Ze, Feng.,Wang, Long.,Li, Ding.,Duan, Jiangbo.,...&Guo, Jihong.(2014).Prevalence of venous occlusion in patients referred for lead extraction: implications for tool selection.EUROPACE,16(12),1795-1799.|
|MLA||Li, Xuebin,et al."Prevalence of venous occlusion in patients referred for lead extraction: implications for tool selection".EUROPACE 16.12(2014):1795-1799.|