Superior vena cava syndrome developed in 4 of 1,000 patients in whom a transvenous pacemaker had been implanted. In all cases, endocardial leads were inserted through the cephalic vein and positioned at the apex of the right ventricle. The classical signs and symptoms of superior vena cava hypertension were observed from two weeks to one year after implantation, and the diagnosis was confirmed by cavography. Symptoms resolved following heparin therapy and long-term anticoagulation.
Patients with major hematologic disorders who have hypersplenism and alterations in their immune mechanism are subject to a higher incidence of bacteremia after embolization procedures. In certain instances, these infectious complications can be fatal. Medical splenectomy for hematologic disorders is sometimes complicated by massive splenic infarction and spontaneous rupture; spontaneous rupture appears to be a function of both infarct size and underlying infectious complications. Prophylactic measures can be employed to avoid these complications after interventional splenic embolization.
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