Analysis of Clinical Characteristics and Lead Extraction in Patients With Venous Occlusion Related to Infection of Cardiovascular Implantable Electronic Devices
10.3969/j.issn.1000-3614.2024.09.003
- VernacularTitle:心律植入装置感染相关静脉闭塞患者的临床特征及电极导线拔除情况分析
- Author:
Wenqiong ZHANG
1
,
2
;
Feng ZE
;
Ding LI
;
Cuncao WU
;
Xu ZHOU
;
Yi WEI
;
Xuebin LI
Author Information
1. 北京大学人民医院 心内科,北京 100044
2. 漯河市中心医院 心内科,漯河 462300
- Keywords:
venous occlusion;
pacemaker infection;
venography for venous;
lead extraction
- From:
Chinese Circulation Journal
2024;39(9):859-864
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To assess the clinical characteristics and lead extraction in patients with venous occlusion related to infection of cardiovascular implantable electronic devices. Methods:Clinical data of 405 patients(147 men,mean age[62.4±13.2]years)who underwent lead extraction from January 2020 to January 2024 in Peking University People's Hospital were reviewed.Contrast venography of the access vein was retrospectively analyzed.The patients were divided into venous occlusion group(n=119)and non-venous occlusion group(n=286)according to the presence or absence of venous occlusion.The clinical characteristics and lead extraction of patients in two groups were analyzed. Results:Occlusion of the access vein occurred in 119 patients(29.4%).The subclavian vein was occluded in 48 cases(40.3%),brachiocephalic vein was occluded in 37 cases(31.1%),axillary vein was occluded in 30 cases(25.2%),superior vena cava was occluded in 4 cases(3.4%).There were no significant differences between venous occlusion group and non-venous occlusion group in terms of age,sex,device type,number of leads,or anticoagulation therapy(all P>0.05).Time from implant of the initial leads was significantly longer in the venous occlusion group than in the non-venous occlusion group([10.4±3.8]years vs.[5.9±4.1]years,P=0.042).Clinical extraction success rate and complications were similar between the venous occlusion group and the non-venous occlusion group(both P>0.05).Procedural duration and fluoroscopy exposure time were significantly lower in non-venous occlusion group than in the venous occlusion group(both P<0.05).Patients in the venous occlusion group required more advanced tools(such as laser sheaths,evolution sheaths,and needle's eye snares)for lead extraction compared to patients in the non-venous occlusion group(84.0%vs.67.1%,P=0.001). Conclusions:The incidence of venous occlusion related to infection of cardiovascular implantable electronic devices is 29.4%.Time from implant of the initial leads is significantly longer and lead extraction is more difficult in patients with venous occlusion,and requires more advanced tools and more time to achieve the successful lead extraction.
