caa a22 4500 606216847 CHVBK 20210128101105.0 cr unu---uuuuu 210128e20151101xx s 000 0 eng 10.1007/s00701-015-2547-9 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2547-9 Vagus nerve stimulation lead removal or replacement: surgical technique, institutional experience, and literature overview [Elektronische Daten] [Marlien Aalbers, Kim Rijkers, Sylvia Klinkenberg, Marian Majoie, Erwin Cornips] Background: With the growing use of vagus nerve stimulation (VNS) as a treatment for refractory epilepsy, there is a growing demand for complete removal or replacement of the VNS system. We evaluate the safety and efficacy of complete removal or replacement of the VNS system and provide an extensive description of our surgical technique. Methods: We retrospectively reviewed our patient registry for all VNS surgeries performed between January 2007 (the year of our first complete removal) and May 2014. In order to assess patient satisfaction, a written questionnaire was sent to patients or their caregivers. Additionally, we reviewed all literature on this topic. Results: The VNS system was completely removed in 22 patients and completely replaced in 13 patients. There were no incomplete removals. Revision surgery was complicated by a small laceration of the jugular vein in two patients and by vocal cord paralysis in one patient. Seizure frequency was unaltered or improved after revision surgery. Electrode-related side effects all improved after revision surgery. Twenty-one studies reported a total of 131 patients in whom the VNS system was completely removed. In 95 patients, the system was subsequently replaced. The most frequently reported side effect was vocal cord paresis, which occurred in four patients. Conclusions: Complete removal or replacement of the VNS system including lead and coils is feasible and safe. Although initial results seem promising, further research and longer follow-up are needed to assess whether lead replacement may affect VNS effectiveness. The Author(s), 2015 Vagus nerve stimulation nationallicence Lead nationallicence Revision nationallicence Epilepsy nationallicence Neuromodulation nationallicence VNS : Vagus nerve stimulation nationallicence Aalbers Marlien Department of Neurosurgery, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands aut Rijkers Kim Department of Neurosurgery, Atrium-Orbis Heerlen, PO Box 4446, 6401 CX, Heerlen, The Netherlands aut Klinkenberg Sylvia Department of Neurology, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands aut Majoie Marian Department of Neurology, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands aut Cornips Erwin Department of Neurosurgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands aut Acta Neurochirurgica Springer Vienna 157/11(2015-11-01), 1917-1924 0001-6268 157:11<1917 2015 157 701 https://doi.org/10.1007/s00701-015-2547-9 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2547-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Aalbers Marlien Department of Neurosurgery, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands aut NATIONALLICENCE 700 1- Rijkers Kim Department of Neurosurgery, Atrium-Orbis Heerlen, PO Box 4446, 6401 CX, Heerlen, The Netherlands aut NATIONALLICENCE 700 1- Klinkenberg Sylvia Department of Neurology, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands aut NATIONALLICENCE 700 1- Majoie Marian Department of Neurology, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands aut NATIONALLICENCE 700 1- Cornips Erwin Department of Neurosurgery, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/11(2015-11-01), 1917-1924 0001-6268 157:11<1917 2015 157 701