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Göteborgs universitets publikationer

Complications and safety of vagus nerve stimulation: 25 years of experience at a single center

Författare och institution:
David Revesz (Institutionen för neurovetenskap och fysiologi); Bertil Rydenhag (Institutionen för neurovetenskap och fysiologi); Elinor Ben-Menachem (Institutionen för neurovetenskap och fysiologi)
Publicerad i:
Journal of Neurosurgery-Pediatrics, 18 ( 1 ) s. 97-104
ISSN:
1933-0707
Publikationstyp:
Artikel, refereegranskad vetenskaplig
Publiceringsår:
2016
Språk:
engelska
Fulltextlänk:
Sammanfattning (abstract):
OBJECTIVE The goal of this paper was to investigate surgical and hardware complications in a longitudinal retrospective study. METHODS The authors of this registry study analyzed the surgical and hardware complications in 247 patients who underwent the implantation of a vagus nerve stimulation (VNS) device between 1990 and 2014. The mean follow-up time was 12 years. RESULTS In total, 497 procedures were performed for 247 primary VNS implantations. Complications related to surgery occurred in 8.6% of all implantation procedures that were performed. The respective rate for hardware complications was 3.7%. Surgical complications included postoperative hematoma in 1.9%, infection in 2.6%, vocal cord palsy in 1.4%, lower facial weakness in 0.2%, pain and sensory-related complications in 1.4%, aseptic reaction in 0.2%, cable discomfort in 0.2%, surgical cable break in 0.2%, oversized stimulator pocket in 0.2%, and battery displacement in 0.2% of patients. Hardware-related complications included lead fracture/malfunction in 3.0%, spontaneous VNS turn-on in 0.2%, and lead disconnection in 0.2% of patients. CONCLUSIONS VNS implantation is a relatively safe procedure, but it still involves certain risks. The most common complications are postoperative hematoma, infection, and vocal cord palsy. Although their occurrence rates are rather low at about 2%, these complications may cause major suffering and even be life threatening. To reduce complications, it is important to have a long-term perspective. The 25 years of follow-up of this study is of great strength considering that VNS can be a life-long treatment for many patients. Thus, it is important to include repeated surgeries such as battery and lead replacements, given that complications also may occur with these surgeries.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
MEDICIN OCH HÄLSOVETENSKAP ->
Klinisk medicin ->
Neurologi
Nyckelord:
epilepsy, treatment, neurosurgery, vagus nerve stimulation, VNS, implants, complications, refractory epilepsy, ventricular asystole, partial seizures, intractable, epilepsy, resistant epilepsy, alzheimers-disease, clinical article, onset seizures, children, tolerability, Neurosciences & Neurology, Pediatrics, Surgery
Postens nummer:
239636
Posten skapad:
2016-07-28 15:58

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