{"title":"迷走神经刺激导致耐久性：从广泛的单中心单一操作成人系列的见解。","authors":"Sami Barrit, Marc Zanello, Romain Carron","doi":"10.1016/j.neuchi.2025.101631","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Vagus nerve stimulation (VNS) is an established surgical option for neuromodulation. Lead failure is a significant complication mainly reported in children.</p><p><strong>Methods: </strong>We conducted a retrospective review of all VNS-related surgeries for refractory epilepsy in adults performed by a single experienced surgeon at a French national referral center from November 2011 to March 2023. We analyzed lead survival using Kaplan-Meier estimators and calculated failure rates.</p><p><strong>Results: </strong>The study included 267 patients (144 females, mean age 36.56 years) with a mean follow-up of 4.32 years. Of 235 leads implanted, accumulating 1355 device years, four lead failures (1.74%) were identified. The cumulative 5-year and 10-year lead survival probabilities were 98.14% (95% CI: 96.06%-100%) and 97.33% (95% CI: 94.75%-100%), respectively. The lead failure rate was 0.00295 events per device-year. All lead failures were associated with abnormally high impedance (>10,000 ohms).</p><p><strong>Conclusions: </strong>This study characterizes technical VNS lead durability, with a failure rate comparable to other neuromodulation devices. Lead longevity is influenced by technical specifications, surgical techniques, and patient-related factors. To optimize lead durability, surgeons should consider the latest technical developments, adhere to best practices, and provide proper patient counseling. Future research should focus on refining lead design and implantation techniques to further improve long-term outcomes.</p>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":" ","pages":"101631"},"PeriodicalIF":1.5000,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Vagus nerve stimulation lead durability: Insights from an extensive monocentric single-operator adult series.\",\"authors\":\"Sami Barrit, Marc Zanello, Romain Carron\",\"doi\":\"10.1016/j.neuchi.2025.101631\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Vagus nerve stimulation (VNS) is an established surgical option for neuromodulation. Lead failure is a significant complication mainly reported in children.</p><p><strong>Methods: </strong>We conducted a retrospective review of all VNS-related surgeries for refractory epilepsy in adults performed by a single experienced surgeon at a French national referral center from November 2011 to March 2023. We analyzed lead survival using Kaplan-Meier estimators and calculated failure rates.</p><p><strong>Results: </strong>The study included 267 patients (144 females, mean age 36.56 years) with a mean follow-up of 4.32 years. Of 235 leads implanted, accumulating 1355 device years, four lead failures (1.74%) were identified. The cumulative 5-year and 10-year lead survival probabilities were 98.14% (95% CI: 96.06%-100%) and 97.33% (95% CI: 94.75%-100%), respectively. The lead failure rate was 0.00295 events per device-year. All lead failures were associated with abnormally high impedance (>10,000 ohms).</p><p><strong>Conclusions: </strong>This study characterizes technical VNS lead durability, with a failure rate comparable to other neuromodulation devices. Lead longevity is influenced by technical specifications, surgical techniques, and patient-related factors. To optimize lead durability, surgeons should consider the latest technical developments, adhere to best practices, and provide proper patient counseling. Future research should focus on refining lead design and implantation techniques to further improve long-term outcomes.</p>\",\"PeriodicalId\":51141,\"journal\":{\"name\":\"Neurochirurgie\",\"volume\":\" \",\"pages\":\"101631\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-01-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neurochirurgie\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.neuchi.2025.101631\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurochirurgie","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.neuchi.2025.101631","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Vagus nerve stimulation lead durability: Insights from an extensive monocentric single-operator adult series.
Background: Vagus nerve stimulation (VNS) is an established surgical option for neuromodulation. Lead failure is a significant complication mainly reported in children.
Methods: We conducted a retrospective review of all VNS-related surgeries for refractory epilepsy in adults performed by a single experienced surgeon at a French national referral center from November 2011 to March 2023. We analyzed lead survival using Kaplan-Meier estimators and calculated failure rates.
Results: The study included 267 patients (144 females, mean age 36.56 years) with a mean follow-up of 4.32 years. Of 235 leads implanted, accumulating 1355 device years, four lead failures (1.74%) were identified. The cumulative 5-year and 10-year lead survival probabilities were 98.14% (95% CI: 96.06%-100%) and 97.33% (95% CI: 94.75%-100%), respectively. The lead failure rate was 0.00295 events per device-year. All lead failures were associated with abnormally high impedance (>10,000 ohms).
Conclusions: This study characterizes technical VNS lead durability, with a failure rate comparable to other neuromodulation devices. Lead longevity is influenced by technical specifications, surgical techniques, and patient-related factors. To optimize lead durability, surgeons should consider the latest technical developments, adhere to best practices, and provide proper patient counseling. Future research should focus on refining lead design and implantation techniques to further improve long-term outcomes.
期刊介绍：
Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal.
With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published.
Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.
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