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Subclavian Venogram as a Guide to Lead Implantation
Author(s) -
SPENCER WILLIAM H.,
ZHU DENNIS W.X.,
KIRKPATRICK CINDY,
KILLIP DONNA,
DURAND JEANBERNARD
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.tb00090.x
Subject(s) - medicine , subclavian vein , intracardiac injection , lead (geology) , venipuncture , surgery , axillary vein , thrombosis , catheter , geomorphology , geology
Recent reports have raised doubts regarding the safety and efficacy of the blind subclavian venipuncture technique for intra‐cardiac lead implantation. To permit a more lateral entry, we used a simple subclavian venogram performed through the brachial vein of the ipsilateral arm of 22 consecutive unselected patients undergoing had implantation (19 permanent pacemakers and 3 intracardiac defibriUators). A total of 35 leads were implanted (31 left pectoral and 4 right pectoral). Lead insertion by venogram technique was used successfully in all patients. Two inconsequential arterial punctures occurred. There were no pneumotho‐races, infections, or other complications. Lateral placement should facilitate lead manipulation and minimize “subclavian crush.” The method of ipsilateral venogram guided lead insertion appears to be safe and reliable and deserves consideration in patients who require permanent lead placement via the subclavian vein approach.