Two problems during one pacemaker implantation procedure: axillary vein spasm and subclavian vein compression, or ‘every cloud has a silver lining’
, 2, 1
Abstract
Abstract Cardiac implantable electronic device (CIED) implantation procedures have become an indispensable part of treating the clinical manifestations of arrhythmias and/or heart conduction disorders. The first stage of CIED implantation involves the insertion of cardiac leads into the venous system via cephalic vein (CV) cutdown and/or axillary vein (AV) / subclavian vein (SV) puncture using special kits designated for this purpose. Similar techniques are used for central venous catheter (CVC) placement. Nonetheless, the course and effectiveness of this stage of the procedure may be affected by mediastinal vein anomalies, atypical venous morphometry and/or topography, reflex venospasm, and—in the case of the SV—the very fact of its coursing through the costoclavicular space. The rare coexistence of several unfavorable factors and the degree of such anomalies may sometimes prevent the originally planned approach, which happened in the case presented here.
Keywords: venographyvenospasmvenipuncturevenous compressionsubclavian veinaxillary veinCIEDCVCTOS
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