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Clinical Experience with the Extrathoracic Introducer Insertion Technique
Author(s) -
BYRD CHARLES L.
Publication year - 1993
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1993.tb01810.x
Subject(s) - medicine , subclavian vein , fluoroscopy , clavicle , rib cage , axillary vein , surgery , vein , radiology , catheter , thrombosis , anatomy
The extrathoracic approach to transvenous introducer insertion into the subclavian vein was initially described as an alternative approach in “Safe Introducer Technique for Pacemaker Lead Implantation.” Since this technique was so successful as an alternative approach, it was tried as the primary approach in 213 consecutive cases. The subclavian vein was cannulated in all cases. There were no introducer related complications. The extrathoracic approach cannulates the subclavian vein as it passes over the body of the first rib prior to entering the thoracic inlet. The technique includes maneuvering the introducer needle from the clavicle to the first rib by a series of partial withdrawals and reinsertions, visualized by fluoroscopy, The needle is advanced posteriorly along the rib until the vein is punctured. Orientation is maintained by touching the rib with each maneuver. The early results of the extrathoracic approach reinforces the belief that a complication‐free, transvenous introducer approach can he achieved.