Barazzoni G, Anguissola R, Caprotti A, Rodino C, Marinoni G, Arcidiacono S, Frattini F, Solcia M
Istituto di Radiologia dell'Università, IRCCS Policlinico S. Matteo, Pavia.
Radiol Med. 1997 May;93(5):552-5.
Venous thrombosis is a well-known complication of permanent cardiac pacemaker implantation, particularly, chronic occlusion of the subclavian vein is reported to occur in 20-33% of the cases where the percutaneous approach is performed. We examined 135 asymptomatic patients with digital venography to asses the frequency of venous thromboses causing stenosis and occlusion of the subclavian or anonymous arteries in pacemaker carriers. We considered both one- (44) and two-chamber (91) pacemakers and investigated a possible statistically significant difference between them: we found 21 venous thromboses (15%), seven of them in one-chamber pacemakers (15.9%) and 14 two-chambers pacemakers (15.3%). None of our 94 male and 41 female patients was on anticoagulants or had any evidence of coagulation disorders. Venography was performed 39.3 months (mean) after pacemaker implantation (range: 3-120 months). We conclude that digital venography is a simple and relatively noninvasive method permitting better depiction of subclavian, anonymous and caval veins than Doppler US and also showing some vascular abnormalities which may complicate pacemaker implantation.
静脉血栓形成是永久性心脏起搏器植入术一种众所周知的并发症，特别是据报道，在采用经皮入路的病例中，20% - 33%会发生锁骨下静脉慢性闭塞。我们对135例无症状患者进行了数字静脉造影，以评估起搏器携带者中导致锁骨下动脉或无名动脉狭窄和闭塞的静脉血栓形成频率。我们纳入了单腔起搏器（44例）和双腔起搏器（91例），并研究两者之间可能存在的统计学显著差异：我们发现21例静脉血栓形成（15%），其中单腔起搏器中有7例（15.9%），双腔起搏器中有14例（15.3%）。我们的94例男性患者和41例女性患者均未使用抗凝剂，也没有任何凝血障碍的证据。静脉造影在起搏器植入后平均39.3个月（范围：3 - 120个月）进行。我们得出结论，数字静脉造影是一种简单且相对无创的方法，与多普勒超声相比，它能更好地显示锁骨下静脉、无名静脉和腔静脉，还能显示一些可能使起搏器植入复杂化的血管异常情况。
