Gkouskos, D. (Dimitrios) (2021) Strategies to overcome venous stenosis in cardiac implantable electronic device (CIED) upgrade procedures: A retrospective cohort study. thesis, Medicine.
Full text available on request.Abstract
Cardiac implantable electronic devices (CIEDs), such as pacemakers or implantable cardioverter defibrillators (ICDs), are used to treat conduction abnormalities, arrhythmias, heart failure, and sudden cardiac death. CIEDs often require upgrades due to lead failure or necessity to add extra functions. These upgrades are sometimes hindered by the presence of venous stenosis (VS). Current literature does not extensively report on the options physicians have at their disposal when facing VS in patients undergoing CIED upgrades. For the period between January 2015 and May 2021, we conducted a retrospective cohort study including patients who presented with VS at the time of their CIED upgrade at the Cardiology Department of the UMCG. All patients presenting significant stenosis (> 70%) before a CIED upgrade were eligible for this study. We aimed to investigate which strategies have been used to overcome VS and report their success and complications rates. Out of 417 CIED upgrades, 118 included patients with VS. Strategies used to overcome VS were: "PTA" (n=52), "Dilator dilation" (n=28), "Medial puncture" (n=6), "Lead extraction" (n=11), "Epicardial lead implantation" (n=8), "Contralateral implantation" (n=6), "Leadless pacemaker" (n=1), "Connection change" (n=5), "S-ICD" (n=1). Overall success rate was 93.2%, while success rates for “PTA” and ''Dilator dilation'' were 94.2% and 92.9%, respectively. 2% of all procedures showed major, and 4.2 % minor complications. "PTA" and "Dilator dilation" are efficient first steps in tackling VS. The final choice of a strategy to overcome VS depends on patient characteristics, setting, and operators' experience.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Maass, dr. A.H. |
| Faculty: | Medical Sciences |
| Date Deposited: | 07 Jan 2022 08:22 |
| Last Modified: | 07 Jan 2022 08:22 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2975 |
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