Superior vena cava syndrome after pacemaker implantation treated with direct oral anticoagulation

Nicola Mumoli,Alessandra Colombo,Isabella Evangelista,Antonino Mazzone,Marco Cei

doi:10.1186/s12959-021-00321-7

Abstract

BackgroundSuperior Vena Cava (SVC) syndrome, is a quite rare but serious complication after pacemaker lead implantation; most patients are asymptomatic due to the development of adequate venous collateral circulation.Case presentationWe report a case of a 75-year-old woman who developed SVC syndrome after transvenous pacemaker implantation with complete resolution of the thrombosis after 3 months of oral anticoagulation.ConclusionsGenerally other causes as malignancy are considered to be the most common etiology of SVC syndrome, but benign iatrogenic causes, mainly intravascular devices (central vein catheters, cardiac defibrillators and pacemaker wires), are becoming increasingly common. Procedures performed on venous vasculature, causing a possible intimal injury or vein stenosis, provoked by transvenous leads, seem to be the most reasonable explanation for the observed complication.

Highlights

Superior Vena Cava (SVC) syndrome, is a quite rare but serious complication after pacemaker lead implantation; most patients are asymptomatic due to the development of adequate venous collateral circulation
The patient was free of symptoms and a chest Computed tomography (CT) angiography revealed complete resolution of the thrombosis and the anticoagulant was interrupted without evidence of recurrence 3 months afterward
Symptoms depend on how quickly the obstruction establishes; the insurgence of thrombosis caused by pacemaker leads seems to be unrelated to the time elapsed from the procedure [4]

Summary

Introduction

Superior Vena Cava (SVC) syndrome, is a quite rare but serious complication after pacemaker lead implantation; most patients are asymptomatic due to the development of adequate venous collateral circulation. Background The Superior Vena Cava (SVC) represents the main drainage vessel for the venous blood of the head, neck, upper extremities, and upper chest. SVC syndrome is a very rare but debilitating complication after pacemaker lead implantation.

Results

Conclusion