Venus occlusion in the upper limbs in patients with CIDS

Abstract

Benefits of treatment with cardiological implantable electronic devices have been confirmed in numerous studies. Similarly to other treatment options this therapy is not free from complications. Among them venous stenoses and occlusions are observed. Its presence is related to impaired blood flow in the vessel as an effect of lead presence, endothelial malfunction and procoagulation. Despite vein occlusion is present in 9-11% of patients after device implantation and vein stenosis which is grater then 70% of diameter in 17-38% or even in some groups up to 50%, clinical symptoms are reported only in 1-3% of patients. What is interesting in 13,7% of individuals before implantation venous stenosis over 60% is present and occlusion in 4,4% patients. Significant venous stenosis is more frequently observed on the left side. Among risk factors responsible for stenosis one can find: numer of leads, total diameter of all leads, usage of anticoagulation and antiplatelet drugs, decreased ejection fraction, increased left ventricular end diastolic diameter, left atrial diameter, higher concentration of procoagulation and inflammatory markers. Presence of significant venous stenosis is important mainly before of up-grade procedures or lead replacement and knowledge about venous anatomy allows better planning of the subsequent procedure.