The Influence of Lead-Related Venous Obstruction on the Complexity and Outcomes of Transvenous Lead Extraction

Marek Czajkowski, Wojciech Jacheć, Anna Polewczyk, Jarosław Kosior, Dorota Nowosielecka, Łukasz Tułecki, Paweł Stefańczyk and Andrzej Kutarski
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Marek Czajkowski: Department of Cardiac Surgery, Medical University of Lublin Poland, 20-078 Lublin, Poland
Wojciech Jacheć: 2nd Department of Cardiology, Faculty of Medical Science in Zabrze, Medical University of Silesia, Zabrze, 40-055 Katowice, Poland
Anna Polewczyk: Department of Physiology, Pathophysiology and Clinical Immunology, Collegium Medicum of Jan Kochanowski University, 25-736 Kielce, Poland
Jarosław Kosior: Department of Cardiology, Masovian Specialistic Hospital, 26-617 Radom, Poland
Dorota Nowosielecka: Department of Cardiology, The Pope John Paul II Province Hospital, 22-400 Zamość, Poland
Łukasz Tułecki: Department of Cardiac Surgery, The Pope John Paul II Province Hospital, 22-400 Zamość, Poland
Paweł Stefańczyk: Department of Cardiology, The Pope John Paul II Province Hospital, 22-400 Zamość, Poland
Andrzej Kutarski: Department of Cardiology, Medical University of Lublin Poland, 20-078 Lublin, Poland

IJERPH, 2021, vol. 18, issue 18, 1-17

Abstract: Background: Little is known about lead-related venous stenosis/occlusion (LRVSO), and the influence of LRVSO on the complexity and outcomes of transvenous lead extraction (TLE) is debated in the literature. Methods: We performed a retrospective analysis of venograms from 2909 patients who underwent TLE between 2008 and 2021 at a high-volume center. Results: Advanced LRVSO was more common in elderly men with a high Charlson comorbidity index. Procedure duration, extraction of superfluous leads, occurrence of any technical difficulty, lead-to-lead binding, fracture of the lead being extracted, need to use alternative approach and lasso catheters or metal sheaths were found to be associated with LRVSO. The presence of LRVSO had no impact on the number of major complications including TLE-related tricuspid valve damage. The achievement of complete procedural or clinical success did not depend on the presence of LRVSO. Long-term mortality, in contrast to periprocedural and short-term mortality, was significantly worse in the groups with LRSVO. Conclusions: LRVSO can be considered as an additional TLE-related risk factor. The effect of LRVSO on major complications including periprocedural mortality and on short-term mortality has not been established. However, LRVSO has been associated with poor long-term survival.

Keywords: lead-related venous obstruction; transvenous lead extraction; lead extraction complications; lead extraction complexity (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View complete reference list from CitEc
Citations: View citations in EconPapers (3)

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