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Venous thromboembolism after diaphragm pacing in amyotrophic lateral sclerosis
Kourosh Rezania1, Ori Gottlieb, Amy Guralnick
1Department of Neurology, University of Chicago Medical Center, 5841 S. Maryland Avenue, MC 2030, Chicago, Illinois, 60637 USA.
Introduction:
Patients with amyotrophic lateral sclerosis (ALS) are prone to venous thromboembolism (VTE) and secondary complications. Because there is an increased incidence of VTE after surgical procedures, placement of a Diaphragm Pacing System (DPS) in ALS patients as treatment for respiratory muscle weakness could potentially increase the incidence of VTE, especially in patients with limited mobility.
Methods:
We implanted a DPS in 10 ALS patients who met the criteria for this procedure. They underwent a preoperative evaluation as recommended by the guidelines.
Results:
We report 2 patients with no symptoms of deep vein thrombosis (DVT) before the surgical procedure who then developed perioperative VTE.
Conclusions:
These patients highlight the need to consider preoperative screening for DVT and postoperative thromboprophylaxis in high-risk ALS patients who undergo DPS placement.
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