Axillary vein spasm during cardiac implantable electronic device implantation

• Autorzy: Steckiewicz R. , Gorko D. , Swieton E.B. , Szparecki G. , Stolarz P.
• Języki publikacji: EN

Abstrakty

EN

Background: The technique of axillary vein (AV) or subclavian vein (SV) puncture has become an important alternative to cephalic vein (CV) cutdown as an approach allowing cardiac lead introduction into the venous system during cardiac implantable electronic device (CIED) implantation procedures. Irrespective of the technique used, the injury associated with lead insertion may induce a reflex venous spasm that can even cause total venous obstruction. In order to assess the incidence of AV spasm during AV puncture, we analysed a total of 735 (382 in females and 353 in males; mean age 75 ± 11 years) de novo CIED implantation procedures involving transvenous lead insertion conducted between January 2014 and December 2015. Materials and methods: In 337 patients the leads were introduced via AV puncture only, in 66 patients AV puncture was used in combination with CV cutdown, together yielding a total of 403 procedures (55% of all de novo CIED implantation procedures; mean patient age 72 ± 14 years), out of which we observed 12 cases (mean patient age 57 ± 25 years) of AV spasm (3%). Results: We evaluated only the procedures with unambiguous fluoroscopy images recorded during AV puncture: complete blockage of contrast medium flow through the AV, with preserved flow through the CV or collateral vessels, followed by eventually resumed flow of contrast via the AV. The contrast-enhanced movements of AV walls showed the spasm propagating both proximally and distally along the vessel, while the subsequent vessel wall relaxation occurred along the entire spasm-affected venous segment simultaneously. Conclusions: An AV spasm induced by AV puncture during CIED implantation is a rare phenomenon; however, if severe, it may significantly affect the course of the procedure. (Folia Morphol 2016; 75, 4: 543–549)

• Wydawca: -
• Czasopismo: Folia Morphologica
• Rocznik: 2016
• Tom: 75
• Numer: 4
• Opis fizyczny: p.543-549,fig.,ref.

Twórcy

autor

Steckiewicz R.

• Department of Cardiology, Medical University of Warsaw, Banacha 1A, 02–097 Warsaw, Poland

autor

Gorko D.

• Department of Cardiology, Medical University of Warsaw, Warsaw, Poland

autor

Swieton E.B.

• Department of Cardiology, Medical University of Warsaw, Warsaw, Poland

autor

Szparecki G.

• Department of Cardiology, Medical University of Warsaw, Warsaw, Poland

autor

Stolarz P.

• Department of Cardiology, Medical University of Warsaw, Warsaw, Poland

Bibliografia

• 1. Agarwal AK, Patel BM, Haddad NJ (2007) Central Vein Stenosis: A Nephrologist’s Perspective. Seminars in Dialysis, 20: 53–62. doi: 10.1111/j.1525-139X.2007.00242.
• 2. Belott P (2006) How to access the axillary vein. Heart Rhythm, 3: 366–369.
• 3. Brignole M, Auricchio A, Baron-Esquivias G, Bordachar P, Boriani G, Breithardt OA, Cleland J, Deharo JC, Delgado V, Elliott PM, Gorenek B, Israel CW, Leclercq C, Linde C, Mont L, Padeletti L, Sutton R, Vardas PE (2013) ESC guidelines oncardiac pacing and cardiac resynchronization therapy: the task force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). Europace, 5: 1070–1118.
• 4. Chan NY, Leung WS (2003) Venospasm in contrast venography-guided axillary vein puncture for pacemaker lead implantation. Pacing Clin Electrophysiol, 26: 112–113.
• 5. Chan NY, Liem LB, Mok NS, Wong W (2003) Clinical experience of contrast venography guided axillary vein puncture in biventricular pacing R1. Int J Cardiol. 92: 55–58.
• 6. Charles AK, Gresham GA (1993) Histopathological changes in venous grafts and in varicose and non-varicose veins. J Clin Pathol, 46: 603–606.
• 7. Cooper RM, Krishnan U, Pyatt JR (2010) Central venous spasm during pacemaker insertion. Heart, 96: 1484. doi: 10.1136/hrt.2010.203919.
• 8. Duan X, Ling F, Shen Y, Xu HY (2011) Venous spasm during pacemaker implantation. Anadolu Kardiyol Derg. 11: E24. doi: 10.5152/akd.2011.153.
• 9. Duan X, Ling F, Shen Y, Yang J, Xu HY (2012) Venous spasm during contrast-guided axillary vein puncture for pacemaker or defibrillator lead implantation. Europace, 14: 1008–1011 doi: 10.1093/europace/eus066.
• 10. Duan X, Ling F, Shen Y, Yang J, Xu HY, Tong XS (2013) Efficacy and safety of nitroglycerin for preventing venous spasm during contrast-guided axillary vein puncture for pacemaker or defibrillator leads implantation. Europace, 15: 566–569. doi: 10.1093/europace/eus233.
• 11. Harada Y, Katsume A, Kimata M, Hikosaka T, Yamanaka S, Akashi K, Hosomi Y, Hirano S, Matsubara H (2005) Placement of pacemaker leads via the extrathoracic subclavian vein guided by fluoroscopy and venography in the oblique projection. Heart Vessels, 20: 19–22.
• 12. Hsu JC, Friday J, Lee BK, Azadani PN, Lee RJ, Badhwar N, Tseng ZH, Olgin JE, Marcus GM (2011) Predictors of axillary vein location for vascular access during pacemaker and defibrillator lead implantation. Pacing Clin Electrophysiol, 34: 1585–1592. doi: 10.1111/j.1540-8159.2011.03191.x.
• 13. Jacobs DM, Fink AS, Miller RP, Anderson WR, McVenes RD, Lessar JF, Cobian KE, Staffanson DB, Upton JE, Bubrick MP (1993) Anatomical and morphological evaluation of pacemaker lead compression. Pacing Clin Electrophysiol, 1993; 16: 434–444.
• 14. Nakata A, Harada T, Kontani K, Hirota S (2013) Extrathoracic subclavian venipuncture by using only the J-type guidewire for permanent pacemaker electrode placement. Int Heart J, 54: 129–132.
• 15. Steckiewicz R, Świętoń EB, Stolarz P, Grabowski M (2015) Clinical implications of cephalic vein morphometry in routine cardiac implantable electronic device insertion. Folia Morphol, 74: 458–464. doi: 10.5603/FM.2015.0107.

Identyfikatory

DOI

10.5603/FM.a2016.0027