Aryana Arash, Sobota Kristi D, Esterbrooks Dennis J, Gelbman Andrew I
Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, Massachusetts, and Department of Radiology, University of North Carolina, Chapel Hill, USA.
Am J Cardiol. 2007 Jun 15;99(12):1765-7. doi: 10.1016/j.amjcard.2007.01.065. Epub 2007 Apr 26.
Two cases of superior vena cava syndrome induced by endocardial defibrillator and pacemaker leads are described. The 2 patients had histories of multiple endocardial leads and device upgrades and venous thrombosis. The first patient was treated with laser lead extraction followed by percutaneous venoplasty and stenting. The second patient was treated conservatively with long-term anticoagulation. The 2 patients had symptomatic reduction. In conclusion, superior vena cava syndrome induced by transvenous leads is an uncommon but serious complication. Anticoagulation can be effective in select patients, but in severe cases, thrombolytic therapy or surgical or percutaneous intervention may be required.
本文描述了两例由心内膜除颤器和起搏器导线引起的上腔静脉综合征。这两名患者有多次心内膜导线植入和设备升级史以及静脉血栓形成史。首例患者接受了激光导线拔除术，随后进行经皮静脉成形术和支架置入术。第二例患者采用长期抗凝保守治疗。两名患者症状均减轻。总之，经静脉导线引起的上腔静脉综合征是一种罕见但严重的并发症。抗凝治疗对部分患者可能有效，但在严重病例中，可能需要溶栓治疗或手术或经皮介入治疗。
