Deep Brain Stimulation Generator Replacement in End-Stage Parkinson Disease.
Aged
Deep Brain Stimulation
/ instrumentation
Device Removal
/ methods
Electric Power Supplies
Female
Humans
Implantable Neurostimulators
Male
Middle Aged
Parkinson Disease
/ rehabilitation
Patient Readmission
/ statistics & numerical data
Postoperative Complications
/ epidemiology
Prosthesis Implantation
/ methods
Retrospective Studies
Severity of Illness Index
Surgical Wound Infection
/ epidemiology
Battery life
DBS
Ethics
Generator replacement
Parkinson's disease
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
19
02
2019
revised:
26
04
2019
accepted:
27
04
2019
pubmed:
7
5
2019
medline:
22
1
2020
entrez:
7
5
2019
Statut:
ppublish
Résumé
The decision to replace deep brain stimulation (DBS) generators in end-stage Parkinson disease (PD) is based on the patients' clinical status and the risks of this surgery. The infection rates of initial DBS implantation surgery and generator replacement surgery are well established. But the risks of DBS generator replacement for the severely disabled end-stage PD patient have not been described. A retrospective analysis of all DBS procedures (n = 446) for PD spanning 20 years in a single institution was performed. The focus was on generator replacement procedure performed in end-stage PD. Infections related to DBS surgery were evaluated. Perioperative infections (<90 days) after generator replacements occurred in 0.6% of 172 cases and 2.5% of 232 primary lead implantation. Delayed infections (>90 days) occurred in 2.7% of all cases. Generator replacement was performed in 11 end-stage PD patients. None of these patients developed perioperative or delayed infections, and none were readmitted for medical or surgical complications. DBS generator replacement surgery is low risk, even in patients who have end-stage PD.
Sections du résumé
BACKGROUND
BACKGROUND
The decision to replace deep brain stimulation (DBS) generators in end-stage Parkinson disease (PD) is based on the patients' clinical status and the risks of this surgery. The infection rates of initial DBS implantation surgery and generator replacement surgery are well established. But the risks of DBS generator replacement for the severely disabled end-stage PD patient have not been described.
METHODS
METHODS
A retrospective analysis of all DBS procedures (n = 446) for PD spanning 20 years in a single institution was performed. The focus was on generator replacement procedure performed in end-stage PD. Infections related to DBS surgery were evaluated.
RESULTS
RESULTS
Perioperative infections (<90 days) after generator replacements occurred in 0.6% of 172 cases and 2.5% of 232 primary lead implantation. Delayed infections (>90 days) occurred in 2.7% of all cases. Generator replacement was performed in 11 end-stage PD patients. None of these patients developed perioperative or delayed infections, and none were readmitted for medical or surgical complications.
CONCLUSIONS
CONCLUSIONS
DBS generator replacement surgery is low risk, even in patients who have end-stage PD.
Identifiants
pubmed: 31059853
pii: S1878-8750(19)31230-6
doi: 10.1016/j.wneu.2019.04.233
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e683-e687Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.