Vagus nerve stimulation removal or replacement involving the lead and the electrode: surgical technique, institutional experience and outcome.

Vagus nerve stimulation removal or replacement involving the lead and the electrode: surgical technique, institutional experience and outcome.

World Neurosurg. 2016 Dec 21;:

Authors: Champeaux C, Landré E, Chassoux F, Mann MW, Devaux B, Turak B

Abstract
PURPOSE: To analyse the outcome of epileptic patients who had redo surgery involving the vagus nerve stimulation's lead.
METHODS: We reviewed the clinical and surgical records of all patients who had a complete VNS removal or replacement or any redo surgical procedure involving the system lead at Sainte-Anne Hospital, Paris.
RESULTS: Between the years 1999 and 2016, 41 redo surgical procedures involving the lead / the electrode were achieved, of which 23 complete VNS explantations, 12 complete system replacements, 5 lead changes only and one isolated lead removal.41 % were achieved in female patient. This population has a median age of VNS implantation of 33.6 years, IQR [21.4 - 38.6]. Median time between the VNS implantation and the redo surgery involving the lead was 4.9 years, IQR [2.9 - 8].Reason of VNS removal was mainly lack of clinical effectiveness.No per- or post-operative complication happened neither after complete VNS system removal or lead replacement. The effectiveness of the VNS therapy remained unchanged after lead replacement. No vagus nerve injury was reported nor symptoms suggesting its disabling.
CONCLUSION: Complete removal or replacement of the VNS system including the lead and the electrode is feasible and safe. These procedures should be offer to the patients which do not longer benefit from the VNS or in case of need for lead change.

PMID: 28012885 [PubMed - as supplied by publisher]

http://ift.tt/2ivaAAF