How to Detect and Treat Superior Vena Cava Obstruction Caused by Multiple Pacing/ICD Leads?

  • G. Chiarandà
  • A. Busà
  • G. Muscio
  • A. Lazzaro
  • L. Cavarra
  • T. Regolo
Conference paper


Superior vena cava (SVC) obstruction caused by permanent implantation of leads for pacemakers or defibrillators is not infrequent, having been observed in 35-45% of all cases, and in 20% of cases total occlusion is found 2 years after the intervention [1–3]. Such a high prevalence is observed only if patients are subjected to venography 1 year after implantation, because thrombosis is asymptomatic in the majority of cases owing to the development of collaterals.


Superior Vena Superior Vena Cava Venous Obstruction Superior Vena Cava Syndrome Lead Implantation 
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  1. 1.
    Stoney W, Addestone R, Alford W et al (1996) The incidence of venous thrombosis following long-term transvenous pacing. Ann Thorac Surg 22:166–170CrossRefGoogle Scholar
  2. 2.
    Mazzetti H, Daussaut A, Tentori C et al (1993) Superior vena cava occlusion and/or syndrome related to pacemaker leads. Am Heart J 125:831–837PubMedCrossRefGoogle Scholar
  3. 3.
    Antonelli D, Turgeman Y, Kaveh Z, Artoul S (1989) Short-term thrombosis after transvenous permanent pacemaker insertion. Pacing Clin Electrophysiol 12:280–282PubMedCrossRefGoogle Scholar
  4. 4.
    Spittel PC, Vliestra RE, Hayes DL et al (1990) Venous obstruction due to permanent transvenous pacemaker electrodes: treatment with percutaneous transluminal balloon venoplasty. Pacing Clin Electrophysiol 13:271–274CrossRefGoogle Scholar
  5. 5.
    Phibbs B, Marriot H (1985) Complications of permanent transvenous pacing. N Engl J Med 22:1428–1432CrossRefGoogle Scholar
  6. 6.
    Porath A, Avnun L, Hirsch M, Ovsysshcher I (1987) Right atrial thrombus and recurrent pulmonary emboli secondary to cardiac pacing; a case report and short review of literature. Angiology 38:267CrossRefGoogle Scholar
  7. 7.
    Bogart DB, Collins RH, Montgomerie MA, Dombek SJ, Earnest JB, Fischer EH (1985) Shock late after implantation of a permanent transvenous cardiac pacemaker. Am J Cardiol 55:1241–1242PubMedCrossRefGoogle Scholar
  8. 8.
    Spittell P, Hayes D (1992) Venous complications after insertion of a transvenous pacemaker. Mayo Clin Proc 67:258–265PubMedCrossRefGoogle Scholar
  9. 9.
    Kar AK, Ghosh S, Majumdar A, Mondai M, Dutta I (2000) Venous obstruction after permanent pacing. Indian Heart J 52:431–433PubMedGoogle Scholar
  10. 10.
    Lin CT, Kuo CT, Lin KH, Hsu JS (1999) Superior vena cava syndrome as a complication of transvenous permanent pacemaker implantation. Jpn Heart J 40:477–480PubMedCrossRefGoogle Scholar
  11. 11.
    Bauset R (2002) Pacemaker-induced superior vena cava syndrome: a case report and review of management strategy. Can J Cardiol 18:1229–1232PubMedGoogle Scholar
  12. 12.
    Blackburn T, Dunn M (1988) Pacemaker-induced superior vena cava syndrome: consideration of management. Am Heart J116:893–896CrossRefGoogle Scholar
  13. 13.
    Newall N, Stables R, Palmer N, Ramsdale D (2002) Treatment of superior vena caval obstruction following permanent pacemaker extraction. Pacing Clin Electrophysiol 25:1780–1783PubMedCrossRefGoogle Scholar
  14. 14.
    Sticherling C, Chough SP, Baker RL et al (2001) Prevalence of central venous occlusion in patients with chronic defibrillator leads. Am Heart J 141:813–816PubMedCrossRefGoogle Scholar
  15. 15.
    Goto Y, Abe T, Sekine S, Sakurada T (1998) Long-term thrombosis after transvenous permanent pacemaker implantation. Pacing Clin Electrophysiol 21:1192–1195PubMedCrossRefGoogle Scholar
  16. 16.
    Stokes K, Chem B, Anderson J et al (1995) The encapsulation of polyurethane-insula-ted transvenous cardiac pacemaker leads. Cardiovasc Pathol 4:163–171CrossRefGoogle Scholar
  17. 17.
    Goudevenos JA, Reid PG, Adams PC, Holden MP, Williams DO (1989) Pacemaker induced superior vena cava syndrome: report of four cases and review of the literature. Pacing Clin Electrophysiol 12:1890–1895PubMedCrossRefGoogle Scholar
  18. 18.
    Palatianos GM, Dewanjee MK, Panoutsopoulos G et al (1994) Comparative thrombo-genicity of pacemaker leads. Pacing Clin Electrophysiol 17:141–145PubMedCrossRefGoogle Scholar
  19. 19.
    Furman S, Hayes DL, Holman DR (1993) A practice of cardiac pacing. Futura, NewYorkGoogle Scholar
  20. 20.
    Pavia S, Wilkoff B (2001) The management of surgical complications of pacemaker and implantable cardioverter-defibrillators. Curr Opin Cardiol 16:66–71PubMedCrossRefGoogle Scholar
  21. 21.
    Tan CW, Vijitbenjaronk P, Khuri B (2000) Superior vena cava syndrome due to permanent transvenous pacemaker electrodes: successful treatment with combined thrombolysis and angioplasty. A case report. Angiology 55:963–969Google Scholar
  22. 22.
    Fernandez Vazquez E, Ortega Antelo M, Merlos Navarro S, Martin-Vivaldi Martinez F, Jimenez Lozano G (2002) Superior vena cava syndrome secondary to intracavitary implantation of a pacemaker. Arch Bronconeumol 38:336–338Google Scholar
  23. 23.
    Williams D, Demos N (1974) Thrombosis of superior vena cava caused by pacemaker wire and managed with streptokinase. J Thorac Cardiovasc Surg 68:134–137PubMedGoogle Scholar
  24. 24.
    Gray BH, Olin JW, Graor RA, Young JR, Batholomew JR, Ruschhaupt WF (1991 ) Safety and efficacy of thrombolytic therapy for superior vena cava syndrome. Chest 99:54–59PubMedCrossRefGoogle Scholar
  25. 25.
    Sherry CS, Diamond NG, Meyers TP, Martin RL (1986) Successful treatment of SVC syndrome by venous angioplasty. AJR Am J Roentgenol 147:834–935PubMedGoogle Scholar
  26. 26.
    Charnsangavej C, Carrasco CH, Wallace S, Wright KC, Ogawa K, Richli W, Gianturco C (1986) Stenosis of the vena cava: preliminary assessment of treatment with expandable metallic stents. Radiology 161:295–298PubMedGoogle Scholar
  27. 27.
    Oudkerk M, Kuijpers T, Schmitz P et al (1996) Self-expanding metal stents for palliative treatment of superior vena cava syndrome. Cardiovasc Intervent Radio l19:146–151CrossRefGoogle Scholar
  28. 28.
    Crowe MT, Davies CH, Gaines PA (1995) Percutaneous management of superior vena cava occlusions. Cardiovasc Intervent Radiol 18:367–372PubMedCrossRefGoogle Scholar
  29. 29.
    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. Eur Heart J 23:1465–1470PubMedCrossRefGoogle Scholar
  30. 30.
    al-Saman MM, Fares AM, Rabee HM (2000) Extra-anatomical long-saphenous conduit for decompression of superior vena cava syndrome. Eur J Vasc Surg 19:426–427CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2004

Authors and Affiliations

  • G. Chiarandà
    • 1
  • A. Busà
    • 2
  • G. Muscio
    • 1
  • A. Lazzaro
    • 3
  • L. Cavarra
    • 1
  • T. Regolo
    • 4
  1. 1.Divisione di Cardiologia con UTICAugusta (SR)Italy
  2. 2.Divisione di CardiologiaVittoria (RG)Italy
  3. 3.Divisione di Cardiologia con UTICCaltagirone (CT)Italy
  4. 4.Istituto di CardiologiaOspedale Ferrarotto (CT)Italy

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