Haghjoo, M. and Nikoo, M.H. and Fazelifar, A.F. and Alizadeh, A. and Emkanjoo, Z. and Sadr-Ameli, M.A. (2007) Predictors of venous obstruction following pacemaker or implantable cardioverter-defibrillator implantation: A contrast venographic study on 100 patients admitted for generator change, lead revision, or device upgrade. Europace, 9 (5). pp. 328-332.
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Abstract
Aim: Venous obstruction following transvenous device implantation rarely cause immediate clinical problems. When lead revision or device upgrade is indicated, venous obstruction become a significant challenge. The aim of this study was to determine the predictors of venous obstruction after transvenous device implantation, and to asess likely effects of antiplatelet/anticoagulant drugs in preventing venous thrombosis. Methods and results: Between March 2005 and July 2006, contrast venography was performed in 100 patients who were candidates for generator change, lead revision, or device upgrade. Vessel patency was graded as either completely obstructed, partially obstructed (>70), or patent. The incidence of venous obstruction was 26, with 9 of patients having total obstruction and 17 of patients exhibiting partial obstruction. No statistically significant differences between obstructed and non-obstructed patients were seen for age, sex, indication for device implantation, atrial fibrillation, cardiothoracic ratio, insulation material, operative technique, device type, and manufacturer (all Ps > 0.05). In a univariate analysis, multiple leads (P = 0.033), and presence of dilated cardiomyopathy (P = 0.036) were associated with higher risk of venous obstruction, whereas anticoagulant/ antiplatelet therapy (P = 0.047) significantly reduced incidence of venous obstruction. Multivariate logistic regression analysis showed that only number of the leads (P = 0.039, OR: 2.22, and 95 CI: 1.03-4.76) and antiplatelet/anticoagulant therapy (P = 0.044, OR: 2.79, and 95 CI: 0.98-7.96) were predictors of venous obstruction. Conclusion: Total or partial obstruction of the access veins occurs relatively frequently after pacemaker or ICD implantation. Multiple pacing or ICD leads are associated with an increased risk of venous obstruction, whereas antiplatelet/anticoagulant therapy appears to have a preventive effect on development of access vein thrombosis. © The European Society of Cardiology 2007. All rights reserved.
| Item Type: | Article |
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| Additional Information: | cited By 100 |
| Uncontrolled Keywords: | acetylsalicylic acid; anticoagulant agent; antithrombocytic agent; clopidogrel; dipyridamole; meglumine diatrizoate; ticlopidine; warfarin, absence of side effects; adolescent; adult; age distribution; aged; article; artificial heart pacemaker; complete heart block; congestive cardiomyopathy; contrast radiography; controlled study; defibrillation; defibrillator; device removal; equipment design; female; heart atrium fibrillation; heart ventricle fibrillation; heart ventricle tachycardia; high risk population; human; major clinical study; male; multivariate logistic regression analysis; phlebography; priority journal; risk assessment; risk factor; school child; second degree atrioventricular block; sex difference; sick sinus syndrome; surgical technique; treatment indication; univariate analysis; vascular access; vascular patency; vein occlusion; vein thrombosis, Adolescent; Adult; Aged; Aged, 80 and over; Anticoagulants; Child; Defibrillators, Implantable; Female; Humans; Male; Middle Aged; Multivariate Analysis; Pacemaker, Artificial; Phlebography; Predictive Value of Tests; Prognosis; Prospective Studies; Venous Thrombosis |
| Subjects: | WG Cardiovascular System |
| Divisions: | School of Rehabilitation Sciences |
| Depositing User: | parto mrs bakhtminoo |
| Date Deposited: | 26 Feb 2019 10:55 |
| Last Modified: | 26 Feb 2019 10:55 |
| URI: | http://eprints.iums.ac.ir/id/eprint/11876 |
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