• Yislenz Narváez-Martínez, Pedro Roldán Ramos, John Alexander Hoyos, Diego Culebras, Yaroslau Compta, Ana Cámara, Esteban Muñoz, María-Jose Martí, Francesc Valldeoriola, and Jordi Rumià.
• Unit of Functional Neurology and Neurosurgery, Hospital Clínic de Barcelona, Barcelona, Spain.
• Stereotact Funct Neurosurg. 2019 Jan 1; 97 (2): 101-105.

Background/AimsInternal 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.MethodsA 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.ResultsA 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).ConclusionsInfection 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.© 2019 S. Karger AG, Basel.

28 keywords...

hide…