Risk Factors for Lead-Related Venous Obstruction: A Study of 2909 Candidates for Lead Extraction

Background: our knowledge of lead-related venous stenosis/occlusion (LRVSO) remains limited and there is still controversy regarding the risk factors for LRVSO. Venography is mandatory before transvenous lead extraction (TLE). Methods: we performed a retrospective analysis of venograms in 2909 patie...

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Autores principales:	Marek Czajkowski, Wojciech Jacheć, Anna Polewczyk, Jarosław Kosior, Dorota Nowosielecka, Łukasz Tułecki, Paweł Stefańczyk, Andrzej Kutarski
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	lead-related venous obstruction transvenous lead extraction risk factors for venous obstruction abandoned lead Medicine R
Acceso en línea:	https://doaj.org/article/eda60083050f4e92b4b4b0dda26d2b9a
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spelling	oai:doaj.org-article:eda60083050f4e92b4b4b0dda26d2b9a2021-11-11T17:46:27ZRisk Factors for Lead-Related Venous Obstruction: A Study of 2909 Candidates for Lead Extraction10.3390/jcm102151582077-0383https://doaj.org/article/eda60083050f4e92b4b4b0dda26d2b9a2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/5158https://doaj.org/toc/2077-0383Background: our knowledge of lead-related venous stenosis/occlusion (LRVSO) remains limited and there is still controversy regarding the risk factors for LRVSO. Venography is mandatory before transvenous lead extraction (TLE). Methods: we performed a retrospective analysis of venograms in 2909 patients (39.43% females, average age 66.90 years) who underwent TLE between 2008 and 2021 at high-volume centers. Results: the severity of LRVSO was likely to be dependent on the number of leads in the system (OR = 1.345; <i>p</i> = 0.003), the number of abandoned leads (OR = 1.965; <i>p</i> < 0.001), the presence of coronary sinus leads (OR = 1.184; <i>p</i> = 0.056), male gender (OR = 1.349; <i>p</i> = 0.003) and patient age at first CIED implantation (OR = 1.008; <i>p</i> = 0.021). The presence of permanent atrial fibrillation (OR = 0.666; <i>p</i> < 0.001) and right ventricular diastolic diameter (OR = 0.978; <i>p</i> = 0.006) showed an inverse correlation with the degree of LRVSO. The combined three-model multivariate analysis provided better prediction of LRSVO using the above-mentioned factors than the CHA2DS2-VASc score. Conclusions: the severity of LRVSO is probably dependent on the mechanical impact of the implanted/abandoned leads on the vein wall, therefore the study has demonstrated the central role of system-/procedure-related risk factors. The thrombotic mechanism may be less important, especially long after implantation, and for this reason the combined prediction model for LRVSO in this study was more effective than the CHA2DS2-VASc score.Marek CzajkowskiWojciech JachećAnna PolewczykJarosław KosiorDorota NowosieleckaŁukasz TułeckiPaweł StefańczykAndrzej KutarskiMDPI AGarticlelead-related venous obstructiontransvenous lead extractionrisk factors for venous obstructionabandoned leadMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5158, p 5158 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	lead-related venous obstruction transvenous lead extraction risk factors for venous obstruction abandoned lead Medicine R
spellingShingle	lead-related venous obstruction transvenous lead extraction risk factors for venous obstruction abandoned lead Medicine R Marek Czajkowski Wojciech Jacheć Anna Polewczyk Jarosław Kosior Dorota Nowosielecka Łukasz Tułecki Paweł Stefańczyk Andrzej Kutarski Risk Factors for Lead-Related Venous Obstruction: A Study of 2909 Candidates for Lead Extraction
description	Background: our knowledge of lead-related venous stenosis/occlusion (LRVSO) remains limited and there is still controversy regarding the risk factors for LRVSO. Venography is mandatory before transvenous lead extraction (TLE). Methods: we performed a retrospective analysis of venograms in 2909 patients (39.43% females, average age 66.90 years) who underwent TLE between 2008 and 2021 at high-volume centers. Results: the severity of LRVSO was likely to be dependent on the number of leads in the system (OR = 1.345; <i>p</i> = 0.003), the number of abandoned leads (OR = 1.965; <i>p</i> < 0.001), the presence of coronary sinus leads (OR = 1.184; <i>p</i> = 0.056), male gender (OR = 1.349; <i>p</i> = 0.003) and patient age at first CIED implantation (OR = 1.008; <i>p</i> = 0.021). The presence of permanent atrial fibrillation (OR = 0.666; <i>p</i> < 0.001) and right ventricular diastolic diameter (OR = 0.978; <i>p</i> = 0.006) showed an inverse correlation with the degree of LRVSO. The combined three-model multivariate analysis provided better prediction of LRSVO using the above-mentioned factors than the CHA2DS2-VASc score. Conclusions: the severity of LRVSO is probably dependent on the mechanical impact of the implanted/abandoned leads on the vein wall, therefore the study has demonstrated the central role of system-/procedure-related risk factors. The thrombotic mechanism may be less important, especially long after implantation, and for this reason the combined prediction model for LRVSO in this study was more effective than the CHA2DS2-VASc score.
format	article
author	Marek Czajkowski Wojciech Jacheć Anna Polewczyk Jarosław Kosior Dorota Nowosielecka Łukasz Tułecki Paweł Stefańczyk Andrzej Kutarski
author_facet	Marek Czajkowski Wojciech Jacheć Anna Polewczyk Jarosław Kosior Dorota Nowosielecka Łukasz Tułecki Paweł Stefańczyk Andrzej Kutarski
author_sort	Marek Czajkowski
title	Risk Factors for Lead-Related Venous Obstruction: A Study of 2909 Candidates for Lead Extraction
title_short	Risk Factors for Lead-Related Venous Obstruction: A Study of 2909 Candidates for Lead Extraction
title_full	Risk Factors for Lead-Related Venous Obstruction: A Study of 2909 Candidates for Lead Extraction
title_fullStr	Risk Factors for Lead-Related Venous Obstruction: A Study of 2909 Candidates for Lead Extraction
title_full_unstemmed	Risk Factors for Lead-Related Venous Obstruction: A Study of 2909 Candidates for Lead Extraction
title_sort	risk factors for lead-related venous obstruction: a study of 2909 candidates for lead extraction
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/eda60083050f4e92b4b4b0dda26d2b9a
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Risk Factors for Lead-Related Venous Obstruction: A Study of 2909 Candidates for Lead Extraction

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