Placement of Transvenous Pacemaker and ICD Leads Across Total Chronic Occlusions

Autor:	James P. Hummel, Craig J. McCOTTER, J. Paul Mounsey, J. Michael Mangrum, Liza A. Prudente, John P. DiMarco, John D. Ferguson, J. Fritz Angle
Rok vydání:	2005
Předmět:	Adult Male Pacemaker Artificial medicine.medical_specialty Subclavian Vein Catheterization Lesion medicine Humans Lead (electronics) Aged Brachiocephalic Veins Aged 80 and over Venous Thrombosis Chronic occlusion business.industry Phlebography General Medicine Middle Aged medicine.disease Venous Obstruction Defibrillators Implantable Surgery Venous thrombosis Catheter Chronic Disease Female medicine.symptom Cardiology and Cardiovascular Medicine Lead Placement business Subclavian vein
Zdroj:	Pacing and Clinical Electrophysiology. 28:921-925
ISSN:	1540-8159 0147-8389
DOI:	10.1111/j.1540-8159.2005.00203.x
Popis:	Objective: To establish a method of implantation for device leads across total venous occlusions. Background: Indications for pacemaker and implantable cardiac defibrillator implantation continue to expand. Chronic venous occlusions are increasingly encountered with lead placement. Some degree of obstruction can be as high as 13% before device implantation and 50% after transvenous device implantation. We report an approach of venoplasty/dilatation of chronic total occlusions to allow lead placement. Methods: From January 1, 2002 through December 16, 2004, 1,356 systems (initial and upgrade) were implanted at the University of Virginia. At the time of device implant, seven patients were noted to have chronic venous occlusions and alternative access was precluded. Four of the seven patients had an existing system; the other three received initial implantations. Subsequently, these seven patients had a 5 Fr catheter placed in the basilic/axillary/subclavian vein and a venogram was obtained to demonstrate the area of chronic occlusion. A guide wire was advanced across the lesion for initial recanalization. Dilatation or venoplasty was performed at the occluded site. A guide wire was retained across the lesion and the patient underwent lead implantation. Results: In all seven patients, recanalization was achieved and leads were successfully placed. There were no complications or damage to the vessels or existing leads. Conclusions: Venoplasty or dilatation of chronic total venous occlusion is a safe and effective technique, which allows for placement of transvenous leads.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e3e2f1fae5941d133eadbf4d00a30b4f https://doi.org/10.1111/j.1540-8159.2005.00203.x Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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