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Blind Extrathoracic Subclavian Venipuncture for Pacemaker Implant: A 3‐Year Experience in 250 Patients
Author(s) -
GARDINI ARMANDO,
BENEDINI GIUSEPPE
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.tb01171.x
Subject(s) - medicine , venipuncture , subclavian vein , surgery , implant , lead (geology) , hematoma , subclavian artery , percutaneous , catheter , geomorphology , geology
We report our 3‐year experience using a modification of the percutaneous technique for extrathoracic subclavian Venipuncture proposed by Magney and colleagues for permanent pacing lead placement. Before surgery bony landmarks were marked on the skin according to Maguey's description to identify the needle entry point and the target point corresponding to the ideal location of the extrathoracic portion of the subclavian vein. Then the venipuncture was accomplished by inserting the needle through a standard infraclavicular pacemaker pocket. Two hundred fifty patients undergoing primary pacemaker implant (231 patients) or reimplant or change of mode of pacing (19 patients) were included in the study. The technique was successful in 245 (98%) cases. Inadvertent puncture of the subclavian artery occurred in 5 (2%) patients but in no case did it jeopardize the success of the implant procedure. No major complications were observed. Seven (2.9%) patients experienced early complications unrelated to the venous approach: 2 subclavian vein thrombosis, 5 lead dislodgment in 4 patients, and 1 pocket hematoma. During a mean follow‐up of 15.2 months (range 4–40) no lead or patient related complications occurred. In the present study the blind approach to the extrathoracic portion of the subclavian vein proved to be safe and effective for pacing lead insertion. Further observations are required to establish whether this method extends the lead survival.