Vagus nerve stimulation lead removal or replacement: surgical technique, institutional experience, and literature overview

Acta neurochirurgica
Marlien W AalbersErwin M J Cornips

Abstract

With the growing use of vagus nerve stimulation (VNS) as a treatment for refractory epilepsy, there is a growing demand for complete removal or replacement of the VNS system. We evaluate the safety and efficacy of complete removal or replacement of the VNS system and provide an extensive description of our surgical technique. We retrospectively reviewed our patient registry for all VNS surgeries performed between January 2007 (the year of our first complete removal) and May 2014. In order to assess patient satisfaction, a written questionnaire was sent to patients or their caregivers. Additionally, we reviewed all literature on this topic. The VNS system was completely removed in 22 patients and completely replaced in 13 patients. There were no incomplete removals. Revision surgery was complicated by a small laceration of the jugular vein in two patients and by vocal cord paralysis in one patient. Seizure frequency was unaltered or improved after revision surgery. Electrode-related side effects all improved after revision surgery. Twenty-one studies reported a total of 131 patients in whom the VNS system was completely removed. In 95 patients, the system was subsequently replaced. The most frequently reported side effect was vo...Continue Reading

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Citations

Feb 26, 2016·Acta neurologica Belgica·Mariangela PanebiancoAntonino Pavone
Oct 6, 2018·Neuromodulation : Journal of the International Neuromodulation Society·Jeffrey D LewineBruce J Simon
Sep 25, 2020·Acta neurochirurgica·Pouya EntezamiMatthew A Adamo
Oct 28, 2017·Neuromodulation : Journal of the International Neuromodulation Society·Antonios P MourdoukoutasMarom Bikson
Apr 22, 2020·Nature Biotechnology·Yuxin LiuZhenan Bao
Jul 12, 2017·Physiology & Behavior·Yacine OuahchiEric Verin
Apr 30, 2021·Epilepsy & Behavior Reports·Philipp SpindlerUlf Christoph Schneider
Oct 30, 2020·Seizure : the Journal of the British Epilepsy Association·Dènahin Hinnoutondji ToffaDang Khoa Nguyen

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