Single-Center Complication Analysis Associated with Surgical Replacement of Implantable Pulse Generators in Deep Brain Stimulation
- Resource Type
- Authors
- Esteban Muñoz; Ana Cámara; Yaroslau Compta; John Alexander Hoyos; Francesc Valldeoriola; Jordi Rumià; Pedro Roldan Ramos; Yislenz Narváez-Martínez; María-José Martí; Diego Culebras
- Source
- Stereotactic and Functional Neurosurgery. 97:101-105
- Subject
- Adult
Male
medicine.medical_specialty
Deep brain stimulation
Deep Brain Stimulation
Essential Tremor
medicine.medical_treatment
Single Center
030218 nuclear medicine & medical imaging
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Risk Factors
medicine
Humans
In patient
Adverse effect
Aged
Retrospective Studies
business.industry
Parkinson Disease
Middle Aged
Electrodes, Implanted
Surgery
Implantable Neurostimulators
Increased risk
Minor surgery
Female
Neurology (clinical)
Coagulase
Complication
business
030217 neurology & neurosurgery
- Language
- ISSN
- 1423-0372
1011-6125
Background/Aims: Internal pulse generator (IPG) replacement is considered a relatively minor surgery but exposes the deep brain stimulation system to the risk of infectious and mechanical adverse events. We retrospectively reviewed complications associated with IPG replacement surgery in our center and reviewed the most relevant publications on the issue. Methods: A retrospective analysis of all the IPG replacements performed in our center from January 2003 until March 2018 was performed. A logistic regression model was used to analyze the risk factors associated with IPG infections at our center. Results: A total of 171 IPG replacements in 93 patients were analyzed. The overall rate of replacement complications was 8.8%, whereas the rate of infection was 5.8%. IPG removal was required in 8 out of 10 infected cases. An increased risk of infection was found in patients with subcutaneous thoracic placement of the IPG (OR 5.3, p = 0.016). The most commonly isolated germ was Staphylococcus coagulase negative (60%). We found a non-significant trend towards increased risk of infection in patients with more than 3 replacements (p = 0.07). Conclusions: Infection is the most frequent complication related to IPG replacement. Staphylococcus coagulase negative is the most commonly isolated bacteria causing the infection. According to our results, the subcutaneous thoracic placement represents a greater risk of infection compared to subcutaneous abdominal placement.