• Anders Fytagoridis, Tomas Heard, Jennifer Samuelsson, Peter Zsigmond, Elena Jiltsova, Simon Skyrman, Thomas Skoglund, Terry Coyne, Peter Silburn, and Patric Blomstedt.
• Neurosurgery, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
• Stereotact Funct Neurosurg. 2016 Jan 1; 94 (4): 235-239.

BackgroundDeep brain stimulation (DBS) is a growing treatment modality, and most DBS systems require replacement of the implantable pulse generator (IPG) every few years. The literature regarding the potential impact of adverse events of IPG replacement on the longevity of DBS treatments is rather scarce.ObjectiveTo investigate the incidence of adverse events, including postoperative infections, associated with IPG replacements in a multicenter cohort.MethodsThe medical records of 808 patients from one Australian and five Swedish DBS centers with a total of 1,293 IPG replacements were audited. A logistic regression model was used to ascertain the influence of possible predictors on the incidence of adverse events.ResultsThe overall incidence of major infections was 2.3% per procedure, 3.7% per patient and 1.7% per replaced IPG. For 28 of 30 patients this resulted in partial or complete DBS system removal. There was an increased risk of infection for males (OR 3.6, p = 0.026), and the risk of infection increased with the number of prior IPG replacements (OR 1.6, p < 0.005).ConclusionsThe risk of postoperative infection with DBS IPG replacement increases with the number of previous procedures. There is a need to reduce the frequency of IPG replacements.© 2016 S. Karger AG, Basel.

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