Arrhythmias & electrophysiology
Percutaneous balloon venoplasty for symptomatic lead-related venous stenosis
Authors' conclusion
LRVS can affect any part of the venous system and may be manifested with swelling of the arm, face/neck, or both. Balloon venoplasty is safe and effective, often requires TLE, and is particularly durable when leads no longer cross the stenosed region. Venoplasty is less effective for secondary lymphedema
Study context
- Population
- Patients with symptomatic lead-related venous stenosis unresponsive to >30 days of anticoagulation undergoing venoplasty, Hospital of the University of Pennsylvania, 2014–2020
- Participants
- 18 patients27 venoplasty procedures
- Outcome
- Symptom resolution after balloon venoplasty
Methodological detailssingle-centre, transvenous lead extraction (TLE) performed first if the lesion could not be crossed with a wire
- Single-centre
- TLE performed first if the lesion could not be crossed with a wire
Main finding
As reported in the abstract
Complete symptom resolution
13
72%
Partial resolution due to secondary lymphedema
4
22%
No improvement
1
Time from symptom onset to intervention, complete resolution vs not
195 vs 690 days
P = .02
Observational data: associations, not effects.
Further findings
Symptoms
- Arm swelling
- 9 (50%)
- Facial/neck swelling
- 1 (6%)
- Both
- 8 (44%)
Lead-related venous stenosis (LRVS) location on venography
- Axillary/subclavian veins
- 10 (56%)
- Brachiocephalic vein
- 6 (33%)
- Superior vena cava
- 4 (11%)
Transvenous lead extraction
- Required TLE before venoplasty
- 83%
- Leads still crossing stenosed segment
- 5 of 18 (28%)
Original publication
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