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Venous Obstruction in Asymptomatic Patients Undergoing First Implantation or Revision of a Cardiac Pacemaker or

C C Pieper1, V Weis1, R Fimmers2

  • 1Department of Radiology, University of Bonn, Germany.

Rofo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin
|July 23, 2015
PubMed

Insights

Upper deep vein obstruction is common before cardiac device procedures, especially during revisions. While some risk factors exist, prediction remains difficult, necessitating venography in many cases.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Medical Imaging

Background:

  • Upper deep vein obstruction is a known complication associated with cardiac device implantation and revision.
  • Identifying pre-procedural risk factors is crucial for patient management and complication avoidance.

Purpose of the Study:

  • To determine the incidence of upper deep vein obstruction in patients undergoing cardiac device implantation or revision.
  • To identify potential patient- and device-related risk factors associated with venous obstruction.

Main Methods:

  • Retrospective review of asymptomatic patients undergoing contrast venography before cardiac device procedures (September 2009 - April 2012).
  • Venograms were analyzed to detect venous obstruction.
  • Statistical analysis, including Fisher's exact test and logistic regression, was used to identify risk factors.

Main Results:

  • 11.0% of patients had venous obstruction before first implantation, while 30.1% had obstruction before device revision.
  • Ventricular escape rhythm was linked to obstruction before first implantation.
  • Prior to revision, male sex, longer time since implantation, ventricular escape rhythm, compromised coagulation, phenprocoumon use, and peripheral arterial disease were significant predictors.

Conclusions:

  • Reliable prediction of venous obstruction is challenging despite identified risk factors.
  • Venography is recommended before cardiac device revision or upgrade to prevent complications.
  • The high incidence of deep upper vein obstruction warrants consideration of venography even for first-time device implantation.
Abstract

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