Symptomatic upper extremity venous thrombosis occurred in 3.8% of patients after transvenous lead extraction, with predictors including cancer history and NYHA Class IV heart failure.
Symptomatic upper extremity deep venous thrombosis is a relatively rare (3.8%) but serious complication of transvenous lead extraction, with identifiable risk factors including cancer history, advanced heart failure, and longer lead dwell time.
Absolute Event Rate: 0% vs 0%
ABSTRACT Background Venous thrombosis occurring after TLE procedures is a fairly common but poorly described complication and requires further investigation into its causes. Aim The aim of this study was to identify independent predictors of UEDVT occurrence after TLE procedures. Methods We analyzed data from 504 transvenous lead extraction procedures performed in the hybrid surgery room of the Department of Electrocardiology and Heart Failure at the Medical University of Silesia, Katowice, Poland, between January 2016 and May 2022. All procedures were performed using mechanical‐only techniques. Results In the analyzed period, as a result of 504 transvenous extraction procedures of cardiac implantable electronic device leads, 19 (3.8%) cases of symptomatic venous thrombosis of the upper extremity on the side of the procedure occurred. The mean age of patients who developed the complication was 65.8 ± 13.3 years, and 68.4% were men, which did not differ significantly from the general group. Based on variables selected in the univariate analysis, a logistic regression model of risk factors for UEDVT was calculated. These include a history of cancer disease in patients ( p = 0.0110), heart failure according to the Class IV NYHA scale ( p = 0.0397), advanced longest dwell time ( p = 0.0323), extraction of atrial lead ( p = 0.0368), and the use of mechanical non‐powered telescopic sheaths ( p = 0.0455). As protective factors were assessed, infectious indications for TLE ( p = 0.0288) and the highest platelet concentration ( p = 0.0448). Conclusions Thrombosis is a relatively rare but serious complication. The precise selection of patients at risk of thrombosis after TLE may increase clinical success. It has been shown that an increased risk of thrombosis after TLE occurs in patients with a history of cancer, with heart failure in NYHA Class IV, and platelet concentration is low, in whom TLE is performed for noninfectious reasons, with the use of additional equipment like mechanical non‐powered telescopic sheaths.
Joniec et al. (Fri,) reported a other. Symptomatic upper extremity venous thrombosis occurred in 3.8% of patients after transvenous lead extraction, with predictors including cancer history and NYHA Class IV heart failure.