Cacko Andrzej, Kozyra-Pydyś Eliza, Gawałko Monika, Opolski Grzegorz, Grabowski Marcin
1 Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Warsaw, Poland.
2 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
J Vasc Access. 2019 Sep;20(5):495-500. doi: 10.1177/1129729818815135. Epub 2018 Dec 11.
Venous stenosis or occlusion related to an intracardiac device is a well-known complication of that procedure. There are numerous studies tried to determine predictors of venous stenosis or occlusion; however, most of them investigate the venous system prior to device upgrade, generator replacement, or transvenous lead extraction. Therefore, we aimed to assess the prevalence and determine the predictors of venous stenosis or occlusion following first transevnous cardiac device implantation.
Observational, prospective study included 71 consecutive patients admitted for first transvenous cardiac device implantation. All patients were followed up for 6 months after operation.
Implanted device systems comprised cardioverter defibrillator (n = 26), single-chamber or dual-chamber pacemakers (n = 34), and biventricular pacemakers (n = 11); 88.5% of implantable cardioverter defibrillator leads were single-coils and 11.5% were dual-coils. The incidence of venous stenosis or occlusion within 6-month follow-up was 21.1%. Multivariate logistic regression showed that only diabetes or prediabetes (p = 0.033, odds ratio: 0.17, 95% confidence interval: 0.04-0.87), prolonged procedure time (p = 0.046, odds ratio: 4.54, 95% confidence interval: 1.01-20.12), and perioperative complications (p = 0.021, odds ratio: 7.04, 95% confidence interval: 1.35-36.85) were predictors of venous stenosis or occlusion.
Prolonged implantation time (>60 min) and perioperative complications are associated with an increased risk of venous stenosis or occlusion, whereas diabetes and prediabetes significantly reduce the risk of venous stenosis or occlusion.
与心内装置相关的静脉狭窄或闭塞是该手术一种众所周知的并发症。有许多研究试图确定静脉狭窄或闭塞的预测因素；然而，它们大多在装置升级、发生器更换或经静脉导线拔除之前对静脉系统进行研究。因此，我们旨在评估首次经静脉心脏装置植入后静脉狭窄或闭塞的患病率并确定其预测因素。
观察性前瞻性研究纳入了71例因首次经静脉心脏装置植入而入院的连续患者。所有患者术后随访6个月。
植入的装置系统包括心脏复律除颤器（n = 26）、单腔或双腔起搏器（n = 34）和双心室起搏器（n = 11）；88.5%的植入式心脏复律除颤器导线为单线圈，11.5%为双线圈。6个月随访期内静脉狭窄或闭塞的发生率为21.1%。多因素逻辑回归显示，只有糖尿病或糖尿病前期（p = 0.033，比值比：0.17，95%置信区间：0.04 - 0.87）、手术时间延长（p = 0.046，比值比：4.54，95%置信区间：1.01 - 20.12）和围手术期并发症（p = 0.021，比值比：7.04，95%置信区间：1.35 - 36.85）是静脉狭窄或闭塞的预测因素。
植入时间延长（>60分钟）和围手术期并发症与静脉狭窄或闭塞风险增加相关，而糖尿病和糖尿病前期则显著降低静脉狭窄或闭塞的风险。
