Svc

I got PM in 2017 now 100% blockage. On the 16th they are removing the PM and leads and putting in a stint. I had trouble with head and hands swelling,breathing,headaches. I didn't know what SVC syndrome was. Has anyone had a lead extraction?


7 Comments

Best of luck

by crustyg - 2021-03-07 04:50:12

There's at least one contributor here who has suffered extensive clotting around a lead resulting in Superior Vena Cava syndrome.  Several have had clots around a lead further out.

There are lots of folk here who have had a lead extracted. The most important thing about lead extraction is to have it done by an expert in a centre where they do 100+ extractions a year.  They need specialist equipment to do it, and a lot of experience with using it.  Given these, it's a pretty safe procedure.

But, to be blunt, your SVC syndrome is much more important.  Usually lead removal and stenting is last-resort territory after you've been fully anti-coagulated for some time and it hasn't worked.  Sounds as though you may have a clotting disorder that results in you clotting too easily?

SVC (Superior Vena Cava)

by Gemita - 2021-03-07 05:49:11

Hammer I am so sorry to hear about your diagnosis and I do wish you well.  It sounds as though you need to get those leads extracted and the stent in quickly to help get your blood flowing again.  I hope the procedure is successful with minimum difficulty.  As crustyg says, in the right hands lead extraction can be safe and I hope it will be so for you.

Hammer, as you will know, the superior vena cava (SVC) is a major vein in our upper body.  It carries blood from the head, neck, upper chest, and arms to the heart.  SVC syndrome can occur when the SVC is partially blocked or compressed.  I am assuming this is solely due in your case to a pacemaker lead(s) since your doctors have recommend removal and stent placement to help restore blood flow and ease your symptoms.   

Unfortunately SVC syndrome is a known but rare complication of pacemaker lead implantation which can compress/cause damage to the vein preventing adequate blood flow.  Blockage can also occur as a result of an infection, a tumour, thrombosis or inflammatory condition eventually leading to partial or complete stenosis of the SVC.

Last year I was investigated for potential occlusion of the SVC/subclavian vein but fortunately I subsequently developed a strong network of additional veins (collateral veins) to bypass the obstruction.  I believe my anticoagulation treatment for atrial fibrillation helped keep my blood flowing Hammer so I have avoided the need for intervention.  However I am covered in prominent veins around my device and into my upper left arm and armpit but I am out of pain now.

I wish you every success with treatment and please let us know how it goes.

SVC

by Hammer - 2021-03-07 16:18:31

In January they went in to do a angioplasty and found it was all scar tissue and couldn't get it through. Hematology Dr. Couldn't find anything wrong with my blood work up. The extraction Dr. Is using a laser.

Laser

by Terry - 2021-03-07 19:50:31

A catheter, having a circle of fiber optics within its wall, is passed over the lead. Excimer laser energy passes through the fiber optics, vaporizes any scar tissue that binds the lead to the vessel wall until it reaches the lead tip. The catheter, with the lead (and some scar tissue) now inside, is removed.

Terry

SVC

by Hammer - 2021-03-07 21:35:37

Thank yall for the information and sharing.

Lead extraction

by barnet38 - 2021-03-07 21:44:54

I had a lead change and battery replacement in December.  My lead had been in place for over 20 years, but needed to be replaced because it had fractured.  I had to decide between extracting the malfunctioning lead or capping it off and placing a new lead.  I chose extraction because I am young (39) and have no health conditions other than congenital complete heart block.  I had the procedure done at a large university hospital by an EP who specializes in extraction.

My EP used a laser tipped sheath to separate the lead from the walls of my vein.  I was under general anesthesia during the procedure.  The lead broke approximately 2/3 of the way into the extraction, but he was able to remove the remaining portion of wire by approaching it from the femoral vein.  I am slender, so this caused some bruising in the left groin area.  After the surgery, I had to lay flat for 4-5 hours due to the groin incisions, and had to stay in the hospital for one night.  

The recovery was a little longer than a normal battery replacement.  I did a lot of relaxing for the first few days because I was having trouble with the groin incision on the left side.  The groin incision on the right side was tender, but healed more quickly.  I recommend taking it easy for the first few days so those incisions can heal.

SVC

by Hammer - 2021-03-19 12:16:50

Had my pm and lead extraction on the 16th, shoulder is really sore but no more symptoms. A 80mm stint was placed in the SVC and the scar tissue removed. My swelling in the head and arms is gone and I can breathe again. It's been good even with the soreness. My PM was only needed less than 1% of the time and is being managed by medications.

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