Balloon Angioplasty

I know that this isn't neccessarily a question for pacemaker patients... Many of us have other problems with our hearts, and I was hoping that someone could shed some light for me.

I was diagnosed last week with Superior Vena Cava Syndrome. In other words, my superior vena cava, the vein that my pacemaker leads run through, is blocked. It is blocked because of scar tissue due to multiple ablations to my sinus node.

My doctors were considering open heart surgery, or placing a stent with pacemaker and lead removal and replacement. They have now decided to avoid surgery if possible and try just ballooning the vein in hopes that it will clear the blockage.

Does anyone have any experiance with balloon angioplasty? I will be having this procedure done without placing a stent because of my pacmaker leads. My doctor has said that they may make several attempts to open the vein since a stent cannot be used.

Has anyone ever had the ballooning without a stent? I know that most blockages that are opened this way are caused from heart disease, but in my case it is a mixture of scar tissue and leads.

I have never been through this particular procedure. I was hoping that someone could give me some details on the procedure itself. I know that they will not be going through my groin...because of the location of the blockage, they will have to access it through my neck.

I'm wondering what the odds are that this will work. This complication is very rare, and is not very well documented. I have not been able to find much information. In the few cases that I have found that are similar to mine, I did not find any success with this procedure.

I hope someone has some insight. I feel lost and confused.

Amanda

4 Comments

I had three of these...

by bambi - 2009-07-22 11:07:23

Amanda. They were not only a waste of time and money, but can be risky.Within 2 weeks of each ballooning, the vein collapsed right back. They can't put in a stent because it would compress the leads against the walls of the vein. Some people get relief for up to 6 months with the balloon [they called mine venoplasty], but they told me immediately following the procedure that I would have to have it repeated often. The problem with that is the risk of rupturing the SVC each time. Try it once, it may help, but my advice is not to let them do it more than that. Rupture of the SVC is life threatening. This is a frustrating complication! There doesn't seem to be a consensus for protocal for SVC Syndrome. Most Dr.'s would like us to learn to live with it! It took almost 8 months for a decision to be made on how to handle my case.
Sorry you are going through this!

I Agree

by scadnama - 2009-07-22 12:07:09

I was thinking the same thing about plaque being more pliable than scar tissue, and therefore being easier to compress.
I'm not sure what percentage of my vein is blocked, but during my ablation a couple of weeks ago, they were unable to get the catheters through.
I'm sure my doctors know what they are doing, but I just feel like we are grasping for straws. They have admitted that this is a very rare condition, and there are not may cases to refer to. I know that they are doing their very best, and am confident in their decision.

Amanda

angioplasty/stenting

by golden_snitch - 2009-07-22 12:07:33

just probably one or two more thoughts:

when cardios perform balloon angioplasties or put stents in arteries, they usually treat a blockage caused by plaque. plaque is different than real scar tissue. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. so i would guess it's much "softer" than scar tissue, and therefore easier to be pressed against the wall of the vein or artery.

i'm on warfarin for stenosis in two other veins, not the svc. it makes the blood thinner so it can flow through narrow veins more easily. might be worth a try for you. i don't know how bad your blockage is, but if the doctors think they can get a balloon catheter it, there seems to be some volume left.

inga

Prayers!

by tcrabtree85 - 2009-07-23 10:07:38

Amanda,
I have spent time looking for research also and seem to still not be able to find much. I think at this point on your journey all you can do is relax and trust that God took you to this EP to figure out why you were so weak.
I know the cardiologist have spent hours studying what to do with your case and they will figure something out. My prayer for you was that you would not have to have open heart. So I guess what i'm telling you is things will come together.
Keep your head up and get rest my dear sister. Stay strong and know you have people all around sending out some prayers for you and your husband and these Dr's who are going to figure out a solution so someday soon you can have a little Amanda walking around.

Love ya,
Tammy

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