Novel extrathoracic puncture techniques for pacemaker lead insertion: Pitfalls of the conventional extrathoracic puncture method

Sawasaki, Kohei; Sato, Tsunehisa; Takayama, Yoshiaki; Yokota, Shigeki; Morita, Yasuhiro; Kobayashi, Masakazu; Saito, Makoto; Takanaka, Chiei; Muto, Masahiro

doi:10.1016/j.joa.2012.03.008

Cited by 4 publications

(1 citation statement)

References 5 publications

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“…Many techniques have been utilized for venous access during the placement of cardiac implantable electronic devices (CIEDs) . Over the past several years, practice has shifted from subclavian access to axillary vein access .…”

Section: Introductionmentioning

confidence: 99%

Predictors of successful ultrasound‐guided lead implantation

Ahmed

Gilge

Clark

et al. 2020

Pacing Clinical Electrophis

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Background Technical advances have improved the safety of cardiac implantable electronic device (CIED) insertion, but periprocedural complications persist. Despite ultrasound (US) guidance for vascular access being feasible and exhibiting shorter fluoroscopy times, it is not widely adopted for insertion of CIEDs. Thus, we studied the use of US for CIED insertion to (1) quantify the success rate of venous cannulation, (2) identify predictors of failed cannulation, and (3) quantify the rate of complications using US guidance. Methods We studied 166 consecutive patients who underwent US‐guided CIED implantation. Anatomic parameters of the axillary vein were measured. The primary outcome was success (group 1) or failure (group 2) to obtain vascular access utilizing US guidance. Secondary outcomes included pneumothorax and hematoma. Results Successful US‐guided cannulation occurred in 154 of 166 patients (93%). No patient had a pneumothorax. Hematoma occurred in 1 of 166 patients (0.01%). Group 2 exhibited higher male proportion at 11 of 12 (92%) compared with 94 of 154 (61%) in group 1 (P = .03), increased vein depth at 3.84 versus 2.85 cm (P = .003), more right‐sided implants (P = .03), higher weight at 104.6 versus 85.3 kg (P = .017), higher body mass index at 35.6 versus 29.2 kg/m2 (P = .049), and higher body surface area at 2.24 versus 1.99 m2 (P = .013). Other parameters were statistically nonsignificant. In multivariate analysis, vein depth remained significantly associated with failure. Conclusion Using US guidance for CIED implantation is successful in the vast majority (93%) of patients. Rare cases of unsuccessful cannulation were associated with right‐sided implants and increased venous depth.

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Section: Introductionmentioning

confidence: 99%