title: Removal of Vagus Nerve Stimulator Leads and Reuse of Same Site for Reimplantation: Technique and Experience.
abstract: OBJECTIVE
  This report describes the authors' experience and technique in removing vagus nerve stimulator leads, including coils, and reuse of the same site on the vagus nerve for implantation of new coils.
  
  
  METHODS
  The charts of all patients who underwent complete removal by the authors of vagus nerve stimulator leads between 1 September 2001 and 1 July 2015 were retrospectively reviewed.
  
  
  RESULTS
  Thirty patients underwent 31 surgeries for removal of vagus nerve stimulator leads. Complete removal, including proximal coils around the vagus nerve, was achieved in all cases. Reimplantation was performed immediately at the same location in 24 patients, delayed in 1 patient, and never replaced in 6. Long-term vocal cord paralysis followed 2 of 9 surgeries performed with sharp dissection and followed one of 22 surgeries in which dissection was performed with monopolar microneedle electrocautery.
  
  
  CONCLUSIONS
  Vagus nerve stimulator coils can be removed from the vagus nerve, via monopolar microneedle electrocautery, and the same site reused for immediate reimplantation with relative safety.
authors.affiliation: Department of Neurosurgery of the University of Colorado School of Medicine, Aurora, Colorado, USA; Denver Health and Hospitals, Denver, Colorado, USA; University Hospital Colorado, Aurora, Colorado, USA; Children's Hospital Colorado, Aurora, Colorado, USA. Electronic address: ramesh.kumar@ucdenver.edu.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Department of Neurosurgery of the University of Colorado School of Medicine, Aurora, Colorado, USA; Denver Health and Hospitals, Denver, Colorado, USA; University Hospital Colorado, Aurora, Colorado, USA; Children's Hospital Colorado, Aurora, Colorado, USA.
authors.forename: Ken R
authors.initials: KR
authors.lastname: Winston
authors.affiliation: Department of Neurosurgery of the University of Colorado School of Medicine, Aurora, Colorado, USA; University Hospital Colorado, Aurora, Colorado, USA; Children's Hospital Colorado, Aurora, Colorado, USA.
authors.forename: Zach
authors.initials: Z
authors.lastname: Folzenlogen
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D020878:Device Removal / Q000009:adverse effects / Q000379:methods*; D004564:Electrocoagulation / Q000009:adverse effects / Q000379:methods*; D004567:Electrodes, Implanted; D004827:Epilepsy / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055536:Vagus Nerve Stimulation / Q000295:instrumentation* / Q000379:methods; D014826:Vocal Cord Paralysis / Q000209:etiology; D055815:Young Adult
keywords: Electrocautery; Epilepsy; Vagus nerve stimulator; Vagus nerve stimulator removal