Usefulness of preoperative venography in patients with cardiac implantable electronic devices submitted to lead replacement or device upgrade procedures

Caio Marcos de Moraes Albertini; Katia Regina da Silva; Joaquim Maurício Da Motta Leal Filho; Elizabeth Sartori Crevelari; Martino Martinelli Filho; Francisco Cesar Carnevale; Roberto Costa

doi:10.5935/abc.20180164

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Usefulness of preoperative venography in patients with cardiac implantable electronic devices submitted to lead replacement or device upgrade procedures

Journal article

Open access

Peer reviewed

Usefulness of preoperative venography in patients with cardiac implantable electronic devices submitted to lead replacement or device upgrade procedures

Caio Marcos de Moraes Albertini, Katia Regina da Silva, Joaquim Maurício Da Motta Leal Filho, Elizabeth Sartori Crevelari, Martino Martinelli Filho, Francisco Cesar Carnevale and Roberto Costa

Arquivos brasileiros de cardiologia, Vol.111(5), pp.686-696

11/01/2018

DOI: 10.5935/abc.20180164

PMID: 30281686

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Abstract

Venous obstructions are common in patients with transvenous cardiac implantable electronic devices, but they rarely cause immediate clinical problems. The main consequence of these lesions is the difficulty in obtaining venous access for additional leads implantation. We aimed to assess the prevalence and predictor factors of venous lesions in patients referred to lead reoperations, and to define the role of preoperative venography in the planning of these procedures. From April 2013 to July 2016, contrast venography was performed in 100 patients referred to device upgrade, revision and lead extraction. Venous lesions were classified as non-significant (< 50%), moderate stenosis (51-70%), severe stenosis (71-99%) or occlusion (100%). Collateral circulation was classified as absent, discrete, moderate or accentuated. The surgical strategy was defined according to the result of the preoperative venography. Univariate analysis was used to investigate predictor factors related to the occurrence of these lesions, with 5% of significance level. Moderate venous stenosis was observed in 23%, severe in 13% and occlusions in 11%. There were no significant differences in relation to the device side or the venous segment. The usefulness of the preoperative venography to define the operative tactic was proven, and in 99% of the cases, the established surgical strategy could be performed according to plan. The prevalence of venous obstruction is high in CIED recipients referred to reoperations. Venography is highly indicated as a preoperative examination for allowing the adequate surgical planning of procedures involving previous transvenous leads.

Adult

Aged

Cardiac Resynchronization Therapy - adverse effects

Constriction, Pathologic - diagnostic imaging

Cross-Sectional Studies

Defibrillators, Implantable - adverse effects

Female

Humans

Male

Middle Aged

Pacemaker, Artificial - adverse effects

Phlebography - methods

Postoperative Complications - prevention & control

Preoperative Care - methods

Prevalence

Reoperation - methods

Reoperation - standards

Vascular Diseases - diagnostic imaging

Vascular Diseases - epidemiology

Details

Title: Subtitle: Usefulness of preoperative venography in patients with cardiac implantable electronic devices submitted to lead replacement or device upgrade procedures
Creators: Caio Marcos de Moraes Albertini - Universidade de São Paulo
Katia Regina da Silva - Instituto do Coração (InCor) - Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brazil
Joaquim Maurício Da Motta Leal Filho - Universidade de São Paulo
Elizabeth Sartori Crevelari - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
Martino Martinelli Filho - Universidade de São Paulo
Francisco Cesar Carnevale - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
Roberto Costa - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
Resource Type: Journal article
Publication Details: Arquivos brasileiros de cardiologia, Vol.111(5), pp.686-696
DOI: 10.5935/abc.20180164
PMID: 30281686
NLM abbreviation: Arq Bras Cardiol
ISSN: 0066-782X
eISSN: 1678-4170
Language: English
Date published: 11/01/2018
Academic Unit: Radiology
Record Identifier: 9985180928702771

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