Surgical and Hardware Complications of Deep Brain Stimulation—A Single Surgeon Experience of 519 Cases Over 20 Years
| Autor: | Neha Rai, Paresh K Doshi, Deepak Das |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
Deep brain stimulation
Deep Brain Stimulation medicine.medical_treatment Blepharospasm Single Center 03 medical and health sciences 0302 clinical medicine medicine Humans Lead (electronics) Retrospective Studies Surgeons Intracerebral hemorrhage Respiratory distress business.industry General Medicine Perioperative medicine.disease Electrodes Implanted Anesthesiology and Pain Medicine Neurology Neurology (clinical) medicine.symptom business Complication 030217 neurology & neurosurgery Computer hardware |
| Zdroj: | Neuromodulation: Technology at the Neural Interface. 25:895-903 |
| ISSN: | 1094-7159 |
| Popis: | OBJECTIVE Deep brain stimulation (DBS) surgery has its own set of risks and complications. This study from a single center and a single surgeon analyzes various risk factors for complications and tries to establish if there is a learning curve effect in minimizing the complications. MATERIALS AND METHODS A retrospective analysis of 519 patients (1024 leads) who underwent DBS surgery and 232 patients who underwent implantable pulse generator replacement (IPG), by a single surgeon, between the years 1999 and 2019 was performed. Perioperative and hardware related complications were evaluated. RESULTS The follow-up period ranged from six months to 20 years. Surgery-related complications occurred in 46 (8.9%) cases which included confusion in 31 (5.98%), intracerebral hemorrhage in 7 (1.3%), vasovagal attack in 3 (0.58%), respiratory distress in 2 (0.38%), postoperative aggressiveness in 1 (0.19%), and blepharospasm in 2 (0.38%) patients. Complications related to the DBS hardware were found in 35 cases, including erosion and infection in 22 (2.95%), inaccurate lead placement or migration in 6 (0.6%) lead fracture/extension wire failure in 2 (0.26%), IPG malfunction in 2 (0.26%), and hardware discomfort in 3 (0.4%) cases. In three patients, one lead was repositioned. In cases of infection, 87% of patients had either partial or complete removal of hardware. There was no mortality. The complications were analyzed for every 100 DBS procedures. There was a significant drop in the percentage of complications in from 23% in the first 100 cases to 7% in the last 100 cases (p |
| Databáze: | OpenAIRE |
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