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Evaluation of an Ultrasonically Guided Venepuncture Technique for the Placement of Permanent Pacing Electrodes
Author(s) -
NASH ANTONY,
BUREELL CHRISTOPHER J.,
RING NICHOLAS J.,
MARSHALL ANDREW J.
Publication year - 1998
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.1540-8159.1998.tb00071.x
Subject(s) - medicine , venipuncture , subclavian vein , pneumothorax , clips , surgery , vein , radiology , catheter
We have evaluated a method of puncturing the subclavian vein in its extrathoracic portion using on ultrasound guidance system. Seventy consecutive patients requiring permanent pacemakers were included in the study. The method was successful in 56 (80%) cases (23 dual chamber systems) and unsuitable or unsuccessful in 14 (20%) cases (2 dual chamber systems). The time taken to achieve a successful cannulation of the vein was similar to that taken with conventional subclavian Venepuncture (average time taken for each Venepuncture WAS 31 seconds, range 5–130 seconds). There was a significant “learning curve” in that nearly all of the unsuccessful cases were in the first half of the series. There were no major complications. Computerized Tomography (CT) confirms that the point of entry into the subclavian vein using this technique lies outside the thoracic cavity, thereby minimizing the risk of pneumothorax. This approach to the subclavian vein is an easy technique to learn, with few immediate complications and there maybe less chance of lead fracture due to subclavian crush in the longer term.