BACKGROUND: Deep brain stimulation (DBS) is a growing treatment modality, and most DBS systems require replacement of the implantable pulse generator (IPG) every few years. The literature regarding the potential impact of adverse events of IPG replacement on the longevity of DBS treatments is rather scarce. OBJECTIVE: To investigate the incidence of adverse events, including postoperative infections, associated with IPG replacements in a multicenter cohort. METHODS: The medical records of 808 patients from one Australian and five Swedish DBS centers with a total of 1,293 IPG replacements were audited. A logistic regression model was used to ascertain the influence of possible predictors on the incidence of adverse events. RESULTS: The overall incidence of major infections was 2.3% per procedure, 3.7% per patient and 1.7% per replaced IPG. For 28 of 30 patients this resulted in partial or complete DBS system removal. There was an increased risk of infection for males (OR 3.6, p = 0.026), and the risk of infection increased with the number of prior IPG replacements (OR 1.6, p < 0.005). CONCLUSIONS: The risk of postoperative infection with DBS IPG replacement increases with the number of previous procedures. There is a need to reduce the frequency of IPG replacements.
BACKGROUND: Deep brain stimulation (DBS) is a growing treatment modality, and most DBS systems require replacement of the implantable pulse generator (IPG) every few years. The literature regarding the potential impact of adverse events of IPG replacement on the longevity of DBS treatments is rather scarce. OBJECTIVE: To investigate the incidence of adverse events, including postoperative infections, associated with IPG replacements in a multicenter cohort. METHODS: The medical records of 808 patients from one Australian and five Swedish DBS centers with a total of 1,293 IPG replacements were audited. A logistic regression model was used to ascertain the influence of possible predictors on the incidence of adverse events. RESULTS: The overall incidence of major infections was 2.3% per procedure, 3.7% per patient and 1.7% per replaced IPG. For 28 of 30 patients this resulted in partial or complete DBS system removal. There was an increased risk of infection for males (OR 3.6, p = 0.026), and the risk of infection increased with the number of prior IPG replacements (OR 1.6, p < 0.005). CONCLUSIONS: The risk of postoperative infection with DBS IPG replacement increases with the number of previous procedures. There is a need to reduce the frequency of IPG replacements.
Authors: Kyle T Mitchell; Monica Volz; Aaron Lee; Marta San Luciano; Sarah Wang; Philip A Starr; Paul Larson; Nicholas B Galifianakis; Jill L Ostrem Journal: Stereotact Funct Neurosurg Date: 2019-07-09 Impact factor: 1.875
Authors: Bach X Tran; Giang H Ha; Giang T Vu; Long H Nguyen; Carl A Latkin; Kalpana Nathan; Roger S McIntyre; Cyrus S Ho; Wilson W Tam; Roger C Ho Journal: Int J Environ Res Public Health Date: 2019-06-26 Impact factor: 3.390
Authors: Katja Engel; Torge Huckhagel; Alessandro Gulberti; Monika Pötter-Nerger; Eik Vettorazzi; Ute Hidding; Chi-Un Choe; Simone Zittel; Hanna Braaß; Peter Ludewig; Miriam Schaper; Kara Krajewski; Christian Oehlwein; Katrin Mittmann; Andreas K Engel; Christian Gerloff; Manfred Westphal; Christian K E Moll; Carsten Buhmann; Johannes A Köppen; Wolfgang Hamel Journal: PLoS One Date: 2018-08-02 Impact factor: 3.240