Upper extremity deep venous thrombosis and pulmonary embolism after transvenous lead replacement or upgrade procedures
Carregando...
Citações na Scopus
2
Tipo de produção
article
Data de publicação
2020
Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY
Autores
ALBERTINI, Caio Marcos de Moraes
Citação
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, v.43, n.5, p.495-502, 2020
Resumo
Background Venous obstructions are frequent in patients with transvenous leads, although related clinical findings are rarely reported. After lead replacement or upgrade procedures, these lesions are even more frequent, but there is still no evidence to support this observation. Aim To investigate the incidence and possible risk factors for upper extremity deep venous thrombosis (UEDVT) and pulmonary embolism (PE) after lead replacement or upgrade procedures. Methods Prospective cohort carried out between April 2013 and July 2016. Preoperative evaluation included venous ultrasound and pulmonary angiotomography. Diagnostic exams were repeated postoperatively to detect the study outcomes. Multivariate logistic regression models were used to identify prognostic factors. Results Among the 84 patients included, 44 (52.4%) were female and mean age was 59.3 +/- 15.2 years. Lead malfunctioning (75.0%) was the main surgical procedure indication. Lead removal was performed in 44 (52.4%) cases. The rate of postoperative combined events was 32.6%, with 24 (28.6%) cases of UEDVT and six (7.1%) cases of PE. Clinical manifestations of deep venous thrombosis occurred in 10 (11.9%) patients. Independent prognostic factors for UEDVT were severe collateral circulation in the preoperative venography (odds ratio [OR] 4.7; 95% confidence interval [CI] 1.1-19.8; P = .037) and transvenous lead extraction (OR 27.4; 95% CI 5.8-128.8; P < .0001). Conclusion Reoperations involving previously implanted transvenous leads present high rates of thromboembolic complications. Transvenous lead extraction had a significant impact on the development of UEDVT. These results show the need of further studies to evaluate the role of preventive strategies for this subgroup of patients.
Palavras-chave
artificial, cardiac pacing, color, Doppler, phlebography, pulmonary embolism, transvenous lead extraction, ultrasonography, venous thrombosis
Referências
- Abu-El-Haija B, 2015, J AM HEART ASSOC, V4, DOI 10.1161/JAHA.115.001878
- Bracke F, 2003, PACE, V26, P1649, DOI 10.1046/j.1460-9592.2003.t01-1-00247.x
- Costa R, 2009, PACE, V32, pS247, DOI 10.1111/j.1540-8159.2008.02295.x
- da Costa SSD, 2002, PACE, V25, P1301
- Di Nisio M, 2016, LANCET, V388, P3060, DOI 10.1016/S0140-6736(16)30514-1
- Haghjoo M, 2007, EUROPACE, V9, P328, DOI 10.1093/europace/eum019
- Hanninen Mikael, 2014, Indian Pacing Electrophysiol J, V14, P150
- Harris PA, 2009, J BIOMED INFORM, V42, P377, DOI 10.1016/j.jbi.2008.08.010
- Konstantinides SV, 2014, EUR HEART J, V35, P3033, DOI 10.1093/eurheartj/ehu283
- Korkeila P, 2007, PACE, V30, P199, DOI 10.1111/j.1540-8159.2007.00650.x
- Kraaijpoel N, 2017, THROMB RES, V156, P54, DOI 10.1016/j.thromres.2017.05.035
- Lelakowski J, 2012, ARCH MED SCI, V8, P1027, DOI 10.5114/aoms.2012.28600
- Noheria A, 2016, EUROPACE, V18, P246, DOI 10.1093/europace/euv038
- Novak M, 2009, EUROPACE, V11, P1510, DOI 10.1093/europace/eup216
- Pedersen SB, 2017, EUROPACE, V19, P991, DOI 10.1093/europace/euw124
- Pieper CC, 2015, ROFO-FORTSCHR RONTG, V187, P1029, DOI 10.1055/s-0035-1553351
- Reitsma PH, 2012, ARTERIOSCL THROM VAS, V32, P563, DOI 10.1161/ATVBAHA.111.242818
- Rozmus G, 2005, J INTERV CARD ELECTR, V13, P9, DOI 10.1007/s10840-005-1140-1
- Santini M, 2016, EUROPACE, V18, P1220, DOI 10.1093/europace/euv391
- Stein PD, 2010, AM J MED, V123, P426, DOI 10.1016/j.amjmed.2009.09.037