Venous Stenosis After Transvenous Lead Placement: A Study of Outcomes and Risk Factors in 212 Consecutive Patients

Basil Abu-El-Haija; Prashant D Bhave; Dwayne N Campbell; Alexander Mazur; Denice M Hodgson-Zingman; Vlad Cotarlan; Michael C Giudici

doi:10.1161/JAHA.115.001878

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Venous Stenosis After Transvenous Lead Placement: A Study of Outcomes and Risk Factors in 212 Consecutive Patients

Journal article

Open access

Venous Stenosis After Transvenous Lead Placement: A Study of Outcomes and Risk Factors in 212 Consecutive Patients

Basil Abu-El-Haija, Prashant D Bhave, Dwayne N Campbell, Alexander Mazur, Denice M Hodgson-Zingman, Vlad Cotarlan and Michael C Giudici

Journal of the American Heart Association, Vol.4(8), pp.e001878-e001878

07/31/2015

DOI: 10.1161/JAHA.115.001878

PMCID: PMC4599456

PMID: 26231843

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Abstract

Venous stenosis is a common complication of transvenous lead implantation, but the risk factors for venous stenosis have not been well defined to date. This study was designed to evaluate the incidence of and risk factors for venous stenosis in a large consecutive cohort. A total of 212 consecutive patients (136 male, 76 female; mean age 69 years) with existing pacing or implantable cardioverter-defibrillator systems presented for generator replacement, lead revision, or device upgrade with a mean time since implantation of 6.2 years. Venograms were performed and percentage of stenosis was determined. Variables studied included age, sex, number of leads, lead diameter, implant duration, insulation material, side of implant, and anticoagulant use. Overall, 56 of 212 patients had total occlusion of the subclavian or innominate vein (26%). There was a significant association between the number of leads implanted and percentage of venous stenosis (P=0.012). Lead diameter, as an independent variable, was not a risk factor; however, greater sum of the lead diameters implanted was a predictor of subsequent venous stenosis (P=0.009). Multiple lead implant procedures may be associated with venous stenosis (P=0.057). No other variables approached statistical significance. A significant association exists between venous stenosis and the number of implanted leads and also the sum of the lead diameters. When combined with multiple implant procedures, the incidence of venous stenosis is increased.

Constriction, Pathologic

Humans

Middle Aged

Male

Prosthesis Design

Vascular Diseases - epidemiology

Incidence

Time Factors

Prosthesis Implantation - adverse effects

Aged, 80 and over

Adult

Female

Iowa - epidemiology

Severity of Illness Index

Pacemaker, Artificial - adverse effects

Defibrillators, Implantable - adverse effects

Risk Assessment

Risk Factors

Prosthesis Implantation - instrumentation

Treatment Outcome

Vascular Diseases - diagnosis

Subclavian Vein - diagnostic imaging

Brachiocephalic Veins - diagnostic imaging

Phlebography

Aged

Details

Title: Subtitle: Venous Stenosis After Transvenous Lead Placement: A Study of Outcomes and Risk Factors in 212 Consecutive Patients
Creators: Basil Abu-El-Haija - University of Iowa Division of Cardiology, Department of Medicine, Iowa City, IA (B.A.E.H., P.D.B., D.N.C., A.M., D.M.H.Z., V.C., M.C.G.)
Prashant D Bhave - University of Iowa Division of Cardiology, Department of Medicine, Iowa City, IA (B.A.E.H., P.D.B., D.N.C., A.M., D.M.H.Z., V.C., M.C.G.)
Dwayne N Campbell - University of Iowa Division of Cardiology, Department of Medicine, Iowa City, IA (B.A.E.H., P.D.B., D.N.C., A.M., D.M.H.Z., V.C., M.C.G.)
Alexander Mazur - University of Iowa Division of Cardiology, Department of Medicine, Iowa City, IA (B.A.E.H., P.D.B., D.N.C., A.M., D.M.H.Z., V.C., M.C.G.)
Denice M Hodgson-Zingman - University of Iowa Division of Cardiology, Department of Medicine, Iowa City, IA (B.A.E.H., P.D.B., D.N.C., A.M., D.M.H.Z., V.C., M.C.G.)
Vlad Cotarlan - University of Iowa Division of Cardiology, Department of Medicine, Iowa City, IA (B.A.E.H., P.D.B., D.N.C., A.M., D.M.H.Z., V.C., M.C.G.)
Michael C Giudici - University of Iowa Division of Cardiology, Department of Medicine, Iowa City, IA (B.A.E.H., P.D.B., D.N.C., A.M., D.M.H.Z., V.C., M.C.G.)
Resource Type: Journal article
Publication Details: Journal of the American Heart Association, Vol.4(8), pp.e001878-e001878
DOI: 10.1161/JAHA.115.001878
PMID: 26231843
PMCID: PMC4599456
NLM abbreviation: J Am Heart Assoc
ISSN: 2047-9980
eISSN: 2047-9980
Language: English
Date published: 07/31/2015
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Cardiovascular Medicine; Internal Medicine
Record Identifier: 9984094391302771

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