Extrathoracic subclavian-axillary vein location and morphological features over the first rib for pacemaker and defibrillator lead implantation.

Autor: Vurgun VK; Cardiology Department, Ankara University School of Medicine, Ankara, Turkey., Candemir B; Cardiology Department, Ankara University School of Medicine, Ankara, Turkey., Gerede DM; Cardiology Department, Ankara University School of Medicine, Ankara, Turkey., Goksuluk H; Cardiology Department, Ankara University School of Medicine, Ankara, Turkey., Altin AT; Cardiology Department, Ankara University School of Medicine, Ankara, Turkey., Akyurek O; Cardiology Department, Ankara University School of Medicine, Ankara, Turkey., Erol C; Cardiology Department, Ankara University School of Medicine, Ankara, Turkey.
Jazyk: angličtina
Zdroj: Pacing and clinical electrophysiology : PACE [Pacing Clin Electrophysiol] 2018 May 23. Date of Electronic Publication: 2018 May 23.
DOI: 10.1111/pace.13396
Abstrakt: Background: We aimed to describe the variations of extrathoracic subclavian-axillary vein location and its morphology over the first rib by venography in order to facilitate venous puncture using fluoroscopic landmarks without contrast venography, and evaluate the success rate of punctures, which is made with our method.
Methods: Patients who had undergone de novo lead implantation with the help of prepuncture venography between 2011 and 2015 were enrolled. For detection of the segmental location of the axillary vein, the zones were defined (Zone 1: Posterior, Zone 2: Lateral, Zone 3: Medial) at the first rib by fluoroscopy. Additionally, patients, who underwent venous puncture with our method after January 2017, were evaluated in terms of puncture success.
Results: Four hundred thirty-three patients who had prepuncture contrast venography for defibrillator or pacemaker lead implantation in 2011-2015 were analyzed. The most common position of the axillary vein was found to be over zone 2 (91%) while the zone 1 location was 8.5% and the zone 3 was 0.5%. Venous valves were detected on the first rib in 98 patients. After January 2017, venous puncture using fluoroscopic landmarks was performed to 171 patients. The punctures were successfully performed over zone 2 with our method in 90.7% of the patients.
Conclusions: The most common radioanatomic position of the extrathoracic subclavian-axillary vein was observed at zone 2 according to our method and the probability of presence of venous valve over the first rib is 22%. Additionally, the success rate of puncture using fluoroscopic landmarks over zone 2 was 90.7%.
(© 2018 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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