Percutaneous treatment of the superior vena cava syndrome via an excimer laser sheath in a patient with a single chamber atrial pacemaker.
A 21-year-old woman presented with a pacemaker-associated superior vena cava (SVC) syndrome refractory to medical therapy. In the past, treatment of this condition has involved surgical exploration which is invasive. With the evolution of percutaneous techniques, treatment has included venoplasty and stenting over the pacemaker lead. There is limited experience with a more advanced percutaneous technique in which the lead is extracted by an excimer laser sheath. The extraction is immediately followed by venoplasty and stenting at the site of stenosis with subsequent implantation of a new permanent pacemaker at the previously occluded access site. The patient underwent this procedure which proved to be safe, minimally invasive, and an efficient method of treating SVC syndrome secondary to a single chamber atrial pacemaker.
Garlitski
Ann C
AC
Leon H. Charney Division of Cardiology, New York University Medical Center, 403 East 34 Street, New York, NY 10017, USA. agarlitski@hotmail.com
Swingle
Jad D
JD
Aizer
Anthony
A
Holmes
Douglas S
DS
Bernstein
Neil E
NE
Chinitz
Larry A
LA
D000328:Adult; D001401:Azygos Vein; D016121:Brachiocephalic Veins; D002304:Cardiac Pacing, Artificial; D002404:Catheterization; D020878:Device Removal / Q000379:methods*; D004567:Electrodes, Implanted / Q000009:adverse effects; D005260:Female; D006801:Humans; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D011859:Radiography; D015607:Stents; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*