Open AccessPermanent Pacemaker Implantation via the Iliac Vein: An Alternative in 4 Cases with Contraindications to the Pectoral Approach
Author(s) -
Tsutsumi Koji,
Hashizume Kenichi,
Kimura Naritaka,
Taguchi Shinichi,
Inoue Yoshito,
Kashima Ichiro,
Takahashi Ryuichi
Publication year - 2010
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1016/s1880-4276(10)80037-7
Subject(s) - medicine , surgery , vein , pectoral muscle , axillary vein , radiology , thrombosis
We report the outcome of the iliac vein approach for permanent pacemaker implantation in 4 patients in whom the conventional pectoral approach was not possible. The reasons for using the iliac vein approach were: recurrent lead infections at bilateral pectoral positions in 1 patient; superior vena cava obstruction following cardiac surgery in 2 patients; and a postoperative dermal scar due to right radical mastectomy secondary to a persistent left superior vena cava with absence of the innominate vein in 1 patient. This technique was safe and effective during the mean follow‐up period of 24.3 months. At the latest follow‐up, no patients showed signs of electrophysiological abnormalities. No short‐ or long‐term complications were seen. Conclusions: The iliac vein approach is a less invasive and more feasible alternative without any complications for patients in whom the pectoral approach cannot be used.