open access
Clinical implications of cephalic vein morphometry in routine cardiac implantable electronic device insertion
open access
Abstract
Background: Morphometric parameters of the venous vasculature constitute an important aspect in successful cardiac implantable electronic device (CIED) insertion. The purpose of this study was to present morpho-anatomical variations of the cephalic vein (CV) and their effect on the course of CIED implantation procedures, based on the patients from our centre.
Materials and methods: We analysed contrast venography results obtained during first-time lead placement. Venography was indicated in the cases of problematic lead introduction with either the CV cutdown or axillary/subclavian vein puncture techniques. The 214 cases of venography (15%) performed out of 1425 first-time lead placement in the period 2011–2013 were divided into 9 subgroups according to the most commonly observed CV variations of similar morpho-anatomical features that limited the use of the CV cutdown technique for lead insertion.
Results: The following CV morphometric parameters were found to be unfavourable in terms of lead placement: CV diameter of ≤ 1 mm (18%), sharp curvature of the terminal CV segment as it joined the axillary vein (14%), terminal CV bifurcation (9%), additional CV branches (7%) or tributaries (7%), stenoses (5%), sharply winding course (5%), single CV with a supraclavicular course (4%).
Conclusions: The radiographic records obtained during the procedures allowed us to assess the prevalence of those atypical CV variations in our study group, with graphic presentation of characteristic types and sporadically reported CV variations.
Abstract
Background: Morphometric parameters of the venous vasculature constitute an important aspect in successful cardiac implantable electronic device (CIED) insertion. The purpose of this study was to present morpho-anatomical variations of the cephalic vein (CV) and their effect on the course of CIED implantation procedures, based on the patients from our centre.
Materials and methods: We analysed contrast venography results obtained during first-time lead placement. Venography was indicated in the cases of problematic lead introduction with either the CV cutdown or axillary/subclavian vein puncture techniques. The 214 cases of venography (15%) performed out of 1425 first-time lead placement in the period 2011–2013 were divided into 9 subgroups according to the most commonly observed CV variations of similar morpho-anatomical features that limited the use of the CV cutdown technique for lead insertion.
Results: The following CV morphometric parameters were found to be unfavourable in terms of lead placement: CV diameter of ≤ 1 mm (18%), sharp curvature of the terminal CV segment as it joined the axillary vein (14%), terminal CV bifurcation (9%), additional CV branches (7%) or tributaries (7%), stenoses (5%), sharply winding course (5%), single CV with a supraclavicular course (4%).
Conclusions: The radiographic records obtained during the procedures allowed us to assess the prevalence of those atypical CV variations in our study group, with graphic presentation of characteristic types and sporadically reported CV variations.
Keywords
contrast venography, cephalic vein, transvenous lead placement
About this articleTitle
Clinical implications of cephalic vein morphometry in routine cardiac implantable electronic device insertion
Journal
Issue
Article type
Original article
Pages
458-464
Published online
2015-11-27
Page views
1633
Article views/downloads
1649
DOI
10.5603/FM.2015.0107
Pubmed
Bibliographic record
Folia Morphol 2015;74(4):458-464.
Keywords
contrast venography
cephalic vein
transvenous lead placement
Authors
R. Steckiewicz
E. Świętoń
P. Stolarz
M. Grabowski
