Venous spasm during contrast-guided axillary vein puncture for pacemaker or defibrillator lead implantation

Abstract

Venous spasm is not a rare phenomenon during the contrast-guided puncture of axillary vein and it has an important negative impact on the puncture.

Axillary vein spasm during cardiac implantable electronic device implantation

“…Our findings confirmed the association of this medical phenomenon with advanced age (> 70 years). However, venous spasm was also observed in young patients [9].…”

“…The associated injury to the surrounding tissues as well as to the vein itself may induce reflex vascular spasm. In extreme situations this may lead to a complete occlusion of the venous lumen, which directly affects the course of the procedure, which may indirectly lead to later complications [9,13].…”

“…The factors that may play a role in inducing a reflex spasm include both direct mechanical vascular injury (venous puncture, lead insertion) and compression by the surrounding tissues, temperature changes, chemical factors (drugs, contrast agents), etc. [4,9]. Currently, intraoperative venography is still the only assessment allowing immediate and objective record of the development and course of the medical phenomenon of venous reflex spasm.…”

Vasoconstrictive responses of the cephalic vein during first-time cardiac implantable electronic device placement

“…However, there is another obstacle that may also hinder transvenous lead insertion, and that is reflex vasoconstriction. This aspect of CIED implantation procedures has been mainly reported with respect to large veins [2,3,11].…”

Extrathoracic Subclavian Venipuncture by Using Only the J-type Guidewire for Permanent Pacemaker Electrode Placement

“…2,3) To avoid lead fracture, surgical cutdown of the cephalic vein or extrathoracic subclavian/axillar venipuncture has been recommended. 4,5) Although most pacemaker or cardiac resynchronization therapy needs multiple-lead insertion, it is often difficult to introduce multiple leads with the surgical cut-down of the cephalic vein. Extrathoracic venipuncture is suitable for multiplelead placement and is believed to prevent lead fracture.…”