Thrombosis complicating transvenous pacemaker lead presenting as contralateral internal jugular vein occlusion

Preclavicular Route Following Cephalic Venous Cutdown for Pacemaker or Defibrillator Lead Implantation

“…Venous cutdown avoids inadvertent vascular and lung injury, and prevents the long‐term effect of the subclavian crush syndrome 1,2 . In comparison with subclavian or axillary direct puncture, the well‐known disadvantages of this approach are additional procedure time, technical difficulties with dissection, and the risk of failure due to small size, tortuosity, and clot that may propagate starting in the cul de sac of the tiedoff vein 3 . The guidewire technique through the cephalic vein is largely used in difficult cases, and allows multiple lead implantation through the venotomy 4,5 .…”

“…1,2 In comparison with subclavian or axillary direct puncture, the well-known disadvantages of this approach are additional procedure time, technical difficulties with dissection, and the risk of failure due to small size, tortuosity, and clot that may propagate starting in the cul de sac of the tiedoff vein. 3 The guidewire technique through the cephalic vein is largely used in difficult cases, and allows multiple lead implantation through the venotomy. 4,5 Entering the axillary or subclavian vein in the depths of Mohrenheim's fossa, the cephalic vein normally offers direct access to the central circulation.…”

Internal jugular vein thrombosis secondary to a permanent cardiac pacemaker: an unusual case of lateral neck swelling

“…Clinicians should be wary of this rare cause of lateral neck swelling in patients with a cardiac pacemaker, in order to expedite the necessary investigations and treatment and help prevent potentially serious complications First line treatment for upper extremity venous thrombosis is anticoagulation, initially with heparin and subsequently with long term warfarinisation. 13,20,21 Depending on the degree of occlusion, the patient's symptoms, the veins involved and the cause of the thrombosis, alternate treatment options are available, such as thrombolysis 4 and superior vena cava filters. 13 Our patient's symptoms resolved with heparinisation alone, and she was subsequently placed on long term warfarin.…”

Cardiac rehabilitation in pacing venous occlusions

“…Central venous occlusion in pacing patients is often asymptomatic [80][81][82][83][84] due to development of an adequate venous collateral circulation but can cause more difficulties in patients needing of device revision/upgrade/extraction requiring advanced tools and more time [80][81][82][83][84]. Several pacing venous occlusions have also been described including superior vena cava (SVC) occlusion [84][85][86][87], subclavian vein occlusion [88,89], axillary vein occlusion [90], inferior vena cava (IVC) occlusion [91], subtotal innominate vein occlusion [92], and internal jugular vein occlusion [93]. Moreover permanent pacemaker-related upper extremity deep vein thrombosis has been found [94] having risk factors like diabetes, most frequently, followed by smoking, hypertension, obesity with body mass index ≥30, history of acute myocardial infarction, chronic obstructive pulmonary disease and history of congestive cardiac failure (15%) and responding to anticoagulation therapy while antiplatelets were not found protective [94].…”