Percutaneous management of superior vena cava syndrome in patients with cardiovascular implantable electronic devices.

Heart Rhythm : the Official Journal of the Heart Rhythm Society
James GabrielsLaurence M Epstein

Abstract

There is no consensus regarding the optimal management of cardiovascular implantable electronic device (CIED)-related superior vena cava (SVC) syndrome. We report our experience with transvenous lead extractions (TLEs) in the setting of symptomatic CIED-related SVC syndrome. We reviewed all TLEs performed at a high-volume center over a 14-year period and identified patients in which TLE was performed for symptomatic SVC syndrome. Patient characteristics, extraction details, percutaneous management of SVC occlusions, and clinical follow up data were analyzed. Over a 14-year period, more than 1600 TLEs were performed. Of these, 16 patients underwent TLE for symptomatic SVC syndrome. The mean age was 53.1 ± 12.8 years, and 9 (56.3%) were men. Thirty-seven leads, with a mean dwell time of 5.8 years (range 2-12 years), were extracted. After extraction, 6 patients (37.5%) received an SVC stent. Balloon angioplasty was performed before stenting in 5 cases (31.3%). There was 1 major complication (6.3%) due to an SVC tear that was managed surgically with a favorable outcome. Eleven patients underwent reimplantation of a CIED. Over a median follow-up of 5.5 years (interquartile range 2.0-8.5 years), 12 patients (75%) remained free of sym...Continue Reading

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Related Concepts

Angioplasty, Balloon
Complication
Medical Devices
Male Population Group
Plant Extracts
Surgical Replantation
Superior Vena Cava Syndrome
Treatment Protocols
Superior Vena Cava Structure
Disease Management

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