Advertisement

Journal of Interventional Cardiac Electrophysiology

, Volume 16, Issue 3, pp 203–206 | Cite as

Percutaneous treatment of the superior vena cava syndrome via an excimer laser sheath in a patient with a single chamber atrial pacemaker

  • Ann C. Garlitski
  • Jad D. Swingle
  • Anthony Aizer
  • Douglas S. Holmes
  • Neil E. Bernstein
  • Larry A. Chinitz
CASE REPORT

Abstract

A 21-year-old woman presented with a pacemaker-associated superior vena cava (SVC) syndrome refractory to medical therapy. In the past, treatment of this condition has involved surgical exploration which is invasive. With the evolution of percutaneous techniques, treatment has included venoplasty and stenting over the pacemaker lead. There is limited experience with a more advanced percutaneous technique in which the lead is extracted by an excimer laser sheath. The extraction is immediately followed by venoplasty and stenting at the site of stenosis with subsequent implantation of a new permanent pacemaker at the previously occluded access site. The patient underwent this procedure which proved to be safe, minimally invasive, and an efficient method of treating SVC syndrome secondary to a single chamber atrial pacemaker.

Keywords

Pacemaker Percutaneous treatment Excimer laser sheath 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Bracke, F., Meijer, A., & Van Gelder, B. (2003). Venous occlusion of the access vein in patients referred for lead extraction: Influence of patient and lead characteristics. Pacing and Clinical Electrophysiology, 26, 1649–1652.PubMedCrossRefGoogle Scholar
  2. 2.
    Pavia, S., & Wilkoff, B. (2001). The management of surgical complications of pacemaker and implantable cardioverter-defibrillators. Current Opinion in Cardiology, 16(1), 66–71.PubMedCrossRefGoogle Scholar
  3. 3.
    Love, C. J., Wilkoff, B. L., Byrd, C. L., Belott, P. H., Brinker, J. A., Fearnot, N. E., et al. (2000). Recommendations for extraction of chronically implanted transvenous pacing and defibrillator leads: Indications, facilities, training. North American society of pacing and electrophysiology lead extraction conference faculty. Pacing and Clinical Electrophysiology, 23, 544–551.PubMedCrossRefGoogle Scholar
  4. 4.
    Chan, A. W., Bhatt, D. L., Wilkoff, B. L., Roffi, M., Mukherjee, D., Gray, B. H., et al. (2002). Percutaneous treatment for pacemaker-associated superior vena cava syndrome. Pacing and Clinical Electrophysiology, 25, 1628–1633.PubMedCrossRefGoogle Scholar
  5. 5.
    Youngson, G. G., McKenzie, F. N., & Michol, P. M. (1980). Superior vena cava syndrome: Case report—A complication of permanent transvenous endocardial cardiac pacing requiring surgical correction. American Heart Journal, 99, 503–505.PubMedCrossRefGoogle Scholar
  6. 6.
    Inoue, T., Otaki, M., Nakamoto, S., Zang, Z., & Oku, H. (2001). Surgical treatment of pacemaker induced left innominate occlusion using a spiral vein graft. PACE, 24, 1566–1568.PubMedGoogle Scholar
  7. 7.
    Francis, C. M., Starkey, I. R., Errington, M. L., & Gillespie, I. N. (1995). Venous stenting as treatment for pacemaker-induced superior vena cava syndrome. American Heart Journal, 129, 836–837.PubMedCrossRefGoogle Scholar
  8. 8.
    Slonim, S. M., Semba, C. P., Sze, D. Y., & Dake, M. D. (2000). Placement of SVC stents over pacemaker wires for treatment of SVC syndrome. Journal of Vascular and Interventional Radiology, 11, 512–519.Google Scholar
  9. 9.
    Lanciego, C., Rodriguez, M., Rodriguez, A., Carbonell, M. A., & Garcia, L. G. (2003). Permanent pacemaker-induced superior vena cava syndrome: Successful treatment by endovascular stent. Cardiovascular and Interventional Radiology, 26, 576–579.PubMedCrossRefGoogle Scholar
  10. 10.
    Gilard, M., Perennes, Mansourati, J., Etienne, Y., Fatemi, M., Blanc, J. J., et al. (2002). Stent implantation for the treatment of superior vena cava syndrome related to pacemaker leads. Europace, 4, 155–158.PubMedCrossRefGoogle Scholar
  11. 11.
    Verma, A., & Wilkoff, B. L. (2004). Intravascular pacemaker and defibrillator lead extraction: A state-of-the-art review. Heart Rhythm, 6, 39–745.Google Scholar
  12. 12.
    Teo, N., Sabharwal, T., Rowland, E., Curry, P., & Adam, A. (2002). Treatment of superior vena cava obstruction secondary to pacemaker wires with balloon venoplasty and insertion of metallic stents. European Heart Journal, 23, 1465–1470.PubMedCrossRefGoogle Scholar
  13. 13.
    Wilkoff, B. L., Byrd, C. L., Love, C. J., Hayes, D. L., Sellers, T. D., Schaerf, R., et al. (1999). Pacemaker lead extraction with the laser sheath: Results of the pacing lead extraction with the excimer sheath (PLEXES) trial. Journal of the American College of Cardiology, 33, 1671–1676.PubMedCrossRefGoogle Scholar
  14. 14.
    Byrd, C. L., Wilkoff, B. L., Love, C. J., Seelers, T. D., & Reiser, C. (2002). Clinical study of the laser sheath for lead extraction: The total experience in the United States. PACE, 25, 804–808.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  • Ann C. Garlitski
    • 1
  • Jad D. Swingle
    • 1
  • Anthony Aizer
    • 1
  • Douglas S. Holmes
    • 1
  • Neil E. Bernstein
    • 1
  • Larry A. Chinitz
    • 1
  1. 1.Leon H. Charney Division of CardiologyNew York University Medical CenterNew YorkUSA

Personalised recommendations