Cephalic vein access by modified Seldinger technique for lead implantations

Rademakers, Leonard M.; Bracke, Frank

doi:10.1111/pace.14200

Cited by 6 publications

(8 citation statements)

References 19 publications

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“…The initial search yielded 2904 articles, of which 36 21–56 (39,351 patients) were included in the final analysis. The flow of study selection is depicted in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Different venous approaches for implantation of cardiac electronic devices. A network meta‐analysis

Anagnostopoulos

Kossyvakis

Kousta

et al. 2022

Pacing Clinical Electrophis

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Objectives Many of the complications arising from cardiac device implantation are associated to the venous access used for lead placement. Previous analyses reported that cephalic vein cutdown (CVC) is safer but less effective than subclavian vein puncture (SVP). However, comparisons between these techniques and axillary vein puncture (AVP) – guided either by ultrasound or fluoroscopy – are lacking. Thus, we aimed to compare safety and efficacy of these approaches. Methods We searched for articles assessing at least two different approaches regarding the incidence of pneumothorax and/or lead failure (LF). When available, bleeding and infectious complications as well as procedural success were analyzed. A frequentist random effects network meta‐analysis model was adopted. Results Thirty‐six studies were analyzed. Most articles assessed SVP versus CVC. Compared to SVP, both CVC and AVP were associated with reduced odds of pneumothorax (OR: 0.193, 95%CI: 0.136–0.275 and OR: 0.128, 95%CI: 0.050–0.329; respectively) and LF (OR: 0.63, 95%CI: 0.406–0.976 and OR: 0.425, 95%CI: 0.286–0.632; respectively). No significant differences between AVP and CVC were demonstrated. Limited data suggests no major impact of different approaches on infectious and bleeding complications. Initial CVC approach required significantly more often an alternate/additional venous access for lead placement, compared to both AVP and SVP. No differences between these two were identified. Conclusion Both AVP and CVC seem to decrease incident pneumothorax and LF, compared to SVP. Initial AVP approach seems to decrease the need of alternate venous access, compared to CVC. These results suggest that AVP should be further clinically tested.

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“…The initial search yielded 2904 articles, of which 36 21–56 (39,351 patients) were included in the final analysis. The flow of study selection is depicted in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Different venous approaches for implantation of cardiac electronic devices. A network meta‐analysis

Anagnostopoulos

Kossyvakis

Kousta

et al. 2022

Pacing Clinical Electrophis

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“…By reviewing the literature, we find this to be a novel technique, by means of which we succeed in overcoming the abovementioned long-standing problem. [24][25][26] As a newly introduced solution for old challenge, we suggest using roadmap fluoroscopy guided puncture for cardiac pacemaker implantation in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of axillary vein puncture real-time guided by roadmap fluoroscopy in cardiac pacemaker implantation

Chen

Zhang

et al. 2022

Preprint

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Objective: Roadmap fluoroscopy has never previously been evaluated for axillary vein puncture in clinical practice. Our retrospective cohort study was performed to investigate the efficacy and safety of axillary vein puncture real-time guided by roadmap fluoroscopy in cardiac pacemaker implantation. Methods and Results: A total of 178 patients undergoing axillary vein puncture in permanent pacemaker implantation were included in the present cohort study during a 1-year period at our institution. All procedures were performed by the operators with previous experience in axillary approach. Primary endpoint was defined as axillary vein success rate. Secondary endpoints were venous access site change, time to obtain venous access, procedural time, and complication rate. For the primary outcomes, a higher success rate was observed in the roadmap group compared with the blind puncture group (95.2% vs 78.7%; P<0.001), as well as a lower rate of venous access site change (7.1% vs 35.1%; P <0.001) and shorter time to obtain venous access and procedural time, with lower complications (3.6 % vs 6.4 %; P<0.01). Conclusion: The roadmap fluoroscopy real-time guided axillary venous access is safer and has a better success rate and faster execution time compared with the blind axillary puncture in cardiac pacemaker implantation. However, further larger scale prospective randomized controlled trials are required to confirm the findings.

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“…All device implantations were performed under local anaesthesia and after perioperative administration of 2g intravenous cefazolin. Standard vein access through the cephalic vein was obtained for all leads using a modified Seldinger technique [ 7 ]. Axillary or subclavian venous puncture served as bail-out.…”

Section: Methodsmentioning

confidence: 99%

Ventricular dyssynchrony imaging, echocardiographic and clinical outcomes of left bundle branch pacing and biventricular pacing

Verstappen,

Hautvast,

Jurak

et al. 2024

Indian Pacing and Electrophysiology Journal

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Cephalic vein access by modified Seldinger technique for lead implantations

Cited by 6 publications

References 19 publications

Different venous approaches for implantation of cardiac electronic devices. A network meta‐analysis

Different venous approaches for implantation of cardiac electronic devices. A network meta‐analysis

Efficacy and safety of axillary vein puncture real-time guided by roadmap fluoroscopy in cardiac pacemaker implantation

Ventricular dyssynchrony imaging, echocardiographic and clinical outcomes of left bundle branch pacing and biventricular pacing

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