Surgical explantation of a vagal nerve stimulator accord­­ing to the magnetic resonance imaging protocol


Authors: M. Bláha 1;  M. Tomášek 2;  V. Suchánek 3;  P. Marusič 2;  J. Lisý 3;  M. Tichý 1
Published in: Cesk Slov Neurol N 2019; 82(2): 0
Category: Original Paper
doi: 10.14735/amcsnn2019183

Overview

Aim: An overview of MRI in patients with implanted vagal nerve stimulator (VNS) and the method of surgical explantation of VNS, reflect­­ing the MRI protocol al­low­­ing the subsequent MRI examination without significant limitations.

Patients and methods: MRI can also be safely performed in patients with the implanted VNS device. Head examination and body examination caudal­ly from Th8 can be performed, but only local radiofrequency coils must be used. Before the MRI, the VNS system must be reprogram­med. If the patient has an explanted generator and the larger part of the electrode, the MRI of the entire body can be performed with any com­mon MRI setting. This applies to a situation where after the explantation there is only a 2- cm part of the electrode left –  cor­respond­­ing to the portion of the electrode on the vagal nerve with fixation anchors.

Results: From June 2016 to June 2018, we explanted a VNS with this approach in six patients. Post-operative course of all patients was without complications. Post-operative control was performed using neck X-ray and CT 3D imaging. Imag­­ing methods showed that the remainder of the electrode on the vagal nerve electrode was ≤ 2 cm. Post-operatively, patients did not have swallowing dif­ficulties, hoarseness or voice changes. Four patients have subsequently already undergone MRI without any dif­ficulties or complications.

Conclusion: Surgical explantation of VNS accord­­ing to the MRI protocol, leav­­ing part of the electrode on the vagal nerve and omitt­­ing the complete preparation of the entire electrode on the nerve, reduces the risk of complications and shortens the duration of the operation. The patient can afterwards safely undergo the MRI of the entire body without any limitations in normal technical settings.

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Keywords:

epilepsy – magnetic resonance imaging – vagal nerve stimulation – device removal


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Labels
Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

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