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Cephalic Vein Cutdown Is Superior to Subclavian Puncture as Venous Access for Patients with Cardiac Implantable Devices after Long-Term Follow-Up.

Authors :
Knorr, Dario
Bandorski, Dirk
Bogossian, Harilaos
Iliodromitis, Konstantinos
Schiedat, Fabian
Karosiene, Zana
Mijic, Dejan
Lemke, Bernd
Seyfarth, Melchior
Voß, Sabrina
Knippschild, Stephanie
Aweimer, Assem
Zarse, Markus
Kloppe, Axel
Botsios, Spiridon
Source :
Journal of Clinical Medicine. Feb2024, Vol. 13 Issue 4, p1044. 12p.
Publication Year :
2024

Abstract

Background: Cephalic vein cutdown (CVC) and subclavian vein puncture (SVP) are the most commonly used access sites for transvenous lead placement of cardiac implantable electronic devices (CIEDs). Limited knowledge exists about the long-term patency of the vascular lumen housing the leads. Methods: Among the 2703 patients who underwent CIED procedures between 2005 and 2013, we evaluated the phlebographies of 162 patients scheduled for an elective CIED replacement (median of 6.4 years after the first operation). The phlebographies were divided into four stenosis types: Type I = 0%, Type II = 1–69%, Type III = 70–99%, and Type IV = occlusion. Due to the fact that no standardized stenosis categorization exists, experienced physicians in consensus with the involved team made the applied distribution. The primary endpoint was the occurrence of stenosis Type III or IV in the CVC group and in the SVP group. Results: In total, 162 patients with venography were enrolled in this study. The prevalence of high-degree stenosis was significantly lower in the CVC group (7/89, 7.8%) than in the SVP group (15/73, 20.5%, p = 0.023). In the CVC group, venographies showed a lower median stenosis (33%) than in the SVP group (median 42%). Conclusions: The present study showed that the long-term patency of the subclavian vein is higher after CVC than after SVP for venous access in patients with CIED. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
20770383
Volume :
13
Issue :
4
Database :
Academic Search Index
Journal :
Journal of Clinical Medicine
Publication Type :
Academic Journal
Accession number :
175669074
Full Text :
https://doi.org/10.3390/jcm13041044