Balloon venoplasty for right heart catheterization from the arm in patients with subclavian vein stenosis.

Autor:	Khanal K; Department of Cardiovascular Disease, Memorial Healthcare System, Florida, USA. Email: medicalresearch.kk@gmail.com., Pastor-Cervantes JA; Department of Cardiovascular Disease, Memorial Healthcare System, Florida, USA., Shah S; Department of Cardiovascular Disease, Memorial Healthcare System, Florida, USA., Niu J; Office of Human Research, Memorial Healthcare System, Florida, USA., Roberts J; Department of Cardiovascular Disease, Memorial Healthcare System, Florida, USA.
Jazyk:	angličtina
Zdroj:	The Journal of invasive cardiology [J Invasive Cardiol] 2024 Sep; Vol. 36 (9).
DOI:	10.25270/jic/24.00016
Abstrakt:	Objectives: In the trans-radial era, arm venous access for right heart catheterization (RHC) is rising. Procedural success is affected by many factors, including subclavian/innominate vein stenosis (SVS) and pre-existing wires or catheters. In a study published previously by the same authors, 2% of cases had unsuccessful RHC through the arm, predominantly due to SVS. Since that study, techniques to improve RHC success rates have been developed, including crossing the stenosis with a coronary guidewire, followed by balloon dilatation. We aimed to determine whether subclavian/innominate venoplasty allows successful RHC in patients with SVS. Methods: Our retrospective study included patients who had RHC from the arm between November 1, 2019, and December 31, 2022 that was unsuccessful due to the inability to pass a catheter through the SVS, and then underwent balloon venoplasty. The success rate of completed RHC was then assessed. Results: Out of 2506 RHCs via arm access, 2488 were successful with a catheter alone or over a guidewire. In 18 patients, venoplasty was needed for catheter passage over a guidewire. Post-dilatation, all 18 cases (100%) had successful RHC with a mean procedural time of 35.2 (SD = 15.5) minutes. The most common stenosis site was the subclavian vein in 13 patients (72.2%), and 12 patients (66.7%) had pacemaker/ implantable cardioverter defibrillator wires present. Conclusions: Balloon dilatation of SVS is an efficacious method to improve the success rate of RHC from the arm. It is a safe technique that may prevent cross-over to a different access site, thereby improving patient satisfaction and reducing the possibility of alternate site complications.
Databáze:	MEDLINE
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