Document Detail

Venous occlusion of the access vein in patients referred for lead extraction: influence of patient and lead characteristics.
MedLine Citation:
PMID:  12877695     Owner:  NLM     Status:  MEDLINE    
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.
Frank Bracke; Albert Meijer; Berry Van Gelder
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  26     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-07-24     Completed Date:  2003-12-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1649-52     Citation Subset:  IM    
Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands.
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MeSH Terms
Angiography, Digital Subtraction
Brachiocephalic Veins / radiography
Catheterization, Central Venous*
Contrast Media
Defibrillators, Implantable*
Equipment Failure
Infection / complications
Middle Aged
Pacemaker, Artificial*
Risk Factors
Subclavian Vein / radiography
Venous Thrombosis / etiology*,  radiography
Reg. No./Substance:
0/Contrast Media

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