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Cephalic vein access by modified Seldinger technique for lead implantations
Author(s) -
Rademakers Leonard M.,
Bracke Frank A.
Publication year - 2021
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/pace.14200
Subject(s) - medicine , cephalic vein , seldinger technique , axillary vein , venous access , surgery , subclavian vein , lead (geology) , pneumothorax , vein , catheter , thrombosis , geomorphology , geology
Background Venous access for cardiac implantable electronic devices (CIED) is commonly performed by cephalic venous cut down, or axillary or subclavian vein puncture. The latter technique carries a risk of complications such as pneumothorax or lead crush. Cephalic venous cut down is free of these complications but often less successful due to technical difficulties. We report a highly successful, simplified cephalic venous access with a modified Seldinger technique. Methods We prospectively studied 221 patients undergoing de novo implantation of a one, two, or three lead device system performed over a 1‐year period at our center, and assessed the efficacy of the cephalic vein access including the number of leads successfully placed for each procedure. Results In 83% of patients undergoing CIED implantation, a suitable cephalic vein was present. In respectively 98% and 99% of patients undergoing single‐ or dual‐chamber CIED implantation, lead placement could be performed exclusively via the cephalic vein and in 72% of cardiac resynchronization therapy implants, all three leads were placed via cephalic access. Conclusion A novel, technically simple cephalic venous catheterization technique provides high success rates for any CIED lead implantation.