Clinical Significance of Collateral Superficial Vein Across Clavicle in Patients With Cardiovascular Implantable Electronic Device

Hosoda, Junya; Ishikawa, Toshiyuki; Matsushita, Kohei; Matsumoto, Katsumi; Sugano, Teruyasu; Ishigami, Tomoaki; Kimura, Kazuo; Umemura, Satoshi

doi:10.1253/circj.cj-14-0104

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…Since causes are multifactorial, the literature is controversial as to defining predictive factors of thromboembolic complications in CIED patients. 2 - 11 - 36 - 37 In this respect, the absence of risk factors for venous lesions found in this study sample confirms the importance of preoperative venography in patients requiring lead reoperations, since it was not possible to identify any subgroup of individuals less subject to venous obstructions.…”

Section: Discussionsupporting

confidence: 57%

Usefulness of preoperative venography in patients with cardiac implantable electronic devices submitted to lead replacement or device upgrade procedures

Albertini¹,

Silva²,

Motta-Leal-Filho³

et al. 2018

Arquivos Brasileiros De Cardiologia

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BackgroundVenous obstructions are common in patients with transvenous cardiac implantable electronic devices, but they rarely cause immediate clinical problems. The main consequence of these lesions is the difficulty in obtaining venous access for additional leads implantation.ObjectivesWe aimed to assess the prevalence and predictor factors of venous lesions in patients referred to lead reoperations, and to define the role of preoperative venography in the planning of these procedures.MethodsFrom April 2013 to July 2016, contrast venography was performed in 100 patients referred to device upgrade, revision and lead extraction. Venous lesions were classified as non-significant (< 50%), moderate stenosis (51-70%), severe stenosis (71-99%) or occlusion (100%). Collateral circulation was classified as absent, discrete, moderate or accentuated. The surgical strategy was defined according to the result of the preoperative venography. Univariate analysis was used to investigate predictor factors related to the occurrence of these lesions, with 5% of significance level.ResultsModerate venous stenosis was observed in 23%, severe in 13% and occlusions in 11%. There were no significant differences in relation to the device side or the venous segment. The usefulness of the preoperative venography to define the operative tactic was proven, and in 99% of the cases, the established surgical strategy could be performed according to plan.ConclusionsThe prevalence of venous obstruction is high in CIED recipients referred to reoperations. Venography is highly indicated as a preoperative examination for allowing the adequate surgical planning of procedures involving previous transvenous leads.

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Section: Discussionsupporting

confidence: 57%

Usefulness of preoperative venography in patients with cardiac implantable electronic devices submitted to lead replacement or device upgrade procedures

Albertini¹,

Silva²,

Motta-Leal-Filho³

et al. 2018

Arquivos Brasileiros De Cardiologia

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“…The incidence of venous stenosis following transvenous lead implant documented by contrast venogram is ranging from 25 to 64% (6)(7)(8)(9)(10)(11); this variability is mainly related to the degree of stenosis adopted as inclusion criteria among the different series. In a study by Morani et al (11), severe stenosis (>75%) have been found in 27% of patients referred for CIED revision after a median time from first implantation of 66.7 ± 46.4 months.…”

Section: Central Venous Stenosis Related To Transvenous Leads Epidemi...mentioning

confidence: 99%

“…Venous stenoses are often asymptomatic because of venous collateral formation ensuring venous drainage ( 7 , 8 , 13 , 14 , 16 , 17 ) so that they are usually discovered accidentally at the time of CIED revision. The extension of the collateral circulation increases proportionally with the degree of venous stenosis ( 7 ) and the development of collateral superficial veins across the clavicle has been shown to be a sensitive marker of severe venous obstruction ( 9 ).…”

Section: Central Venous Stenosis Related To Transvenous Leadsmentioning

confidence: 99%

New Insights in Central Venous Disorders. The Role of Transvenous Lead Extractions

Domenichini

Bloa

Carroz

et al. 2022

Front. Cardiovasc. Med.

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Over the last decades, the implementation of new technology in cardiac pacemakers and defibrillators as well as the increasing life expectancy have been associated with a higher incidence of transvenous lead complications over time. Variable degrees of venous stenosis at the level of the subclavian vein, the innominate trunk and the superior vena cava are reported in up to 50% of implanted patients. Importantly, the number of implanted leads seems to be the main risk factor for such complications. Extraction of abandoned or dysfunctional leads is a potential solution to overcome venous stenosis in case of device upgrades requiring additional leads, but also, in addition to venous angioplasty and stenting, to reduce symptoms related to the venous stenosis itself, i.e., the superior vena cava syndrome. This review explores the role of transvenous lead extraction procedures as therapeutical option in case of central venous disorders related to transvenous cardiac leads. We also describe the different extraction techniques available and other clinical indications for lead extractions such as lead infections. Finally, we discuss the alternative therapeutic options for cardiac stimulation or defibrillation in case of chronic venous occlusions that preclude the implant of conventional transvenous cardiac devices.

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EHRA expert consensus statement and practical guide on optimal implantation technique for conventional pacemakers and implantable cardioverter-defibrillators: endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), and the Latin-American Heart Rhythm Society (LAHRS)

et al. 2021

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With the global increase in device implantations, there is a growing need to train physicians to implant pacemakers and implantable cardioverter-defibrillators. Although there are international recommendations for device indications and programming, there is no consensus to date regarding implantation technique. This document is founded on a systematic literature search and review, and on consensus from an international task force. It aims to fill the gap by setting standards for device implantation.

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Clinical Significance of Collateral Superficial Vein Across Clavicle in Patients With Cardiovascular Implantable Electronic Device

Cited by 4 publications

References 24 publications

Usefulness of preoperative venography in patients with cardiac implantable electronic devices submitted to lead replacement or device upgrade procedures

Usefulness of preoperative venography in patients with cardiac implantable electronic devices submitted to lead replacement or device upgrade procedures

New Insights in Central Venous Disorders. The Role of Transvenous Lead Extractions

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