open access

Vol 77, No 3 (2018)
Original article
Submitted: 2017-09-20
Accepted: 2017-12-14
Published online: 2018-01-08
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Vasoconstrictive responses of the cephalic vein during first-time cardiac implantable electronic device placement

R. Steckiewicz1, E. B. Świętoń1, M. Bogdańska1, P. Stolarz1
·
Pubmed: 29345717
·
Folia Morphol 2018;77(3):464-470.
Affiliations
  1. Department of Cardiology, Medical University of Warsaw, Poland, Banacha 1a, Warsaw, Poland

open access

Vol 77, No 3 (2018)
ORIGINAL ARTICLES
Submitted: 2017-09-20
Accepted: 2017-12-14
Published online: 2018-01-08

Abstract

Background: During cardiac implantable electronic device (CIED) implantation procedures cardiac leads have been mostly introduced transvenously. The associated injury to the selected vessel and adjacent tissues may induce reflex vasoconstriction. The aim of the study was to assess the incidence of cephalic vein (CV) vasoconstriction during first-time CIED implantation.
Materials and methods: Of the 146 evaluated first-time CIED implantation procedures conducted in our centre in 2016, we selected those during which CV vasoconstriction was recorded. We focused on the stage of the procedure involving CV cutdown and/or axillary vein (AV)/subclavian vein (SV) puncture for lead insertion. Only cases documented via venography were considered.
Results: Vasoconstriction was observed in 11 patients (5 females and 6 males, mean age 59.0 ± 21.2 years). The presence of this phenomenon affected the stage of CIED implantation involving cardiac lead insertion to the venous system, in severe cases, requiring a change of approach from CV cutdown to AV/SV puncture. The extent of vasoconstriction front propagation was limited to the nearest valves. Histological examinations of collected CV samples revealed an altered spatial arrangement of myocytes in the tunica media at the level of leaflet attachment.
Conclusions: Cephalic vein vasoconstriction is a rare phenomenon associated with accessing the venous system during first-time CIED implantation. The propagation of CV constriction was limited by the location of the nearest valves.

Abstract

Background: During cardiac implantable electronic device (CIED) implantation procedures cardiac leads have been mostly introduced transvenously. The associated injury to the selected vessel and adjacent tissues may induce reflex vasoconstriction. The aim of the study was to assess the incidence of cephalic vein (CV) vasoconstriction during first-time CIED implantation.
Materials and methods: Of the 146 evaluated first-time CIED implantation procedures conducted in our centre in 2016, we selected those during which CV vasoconstriction was recorded. We focused on the stage of the procedure involving CV cutdown and/or axillary vein (AV)/subclavian vein (SV) puncture for lead insertion. Only cases documented via venography were considered.
Results: Vasoconstriction was observed in 11 patients (5 females and 6 males, mean age 59.0 ± 21.2 years). The presence of this phenomenon affected the stage of CIED implantation involving cardiac lead insertion to the venous system, in severe cases, requiring a change of approach from CV cutdown to AV/SV puncture. The extent of vasoconstriction front propagation was limited to the nearest valves. Histological examinations of collected CV samples revealed an altered spatial arrangement of myocytes in the tunica media at the level of leaflet attachment.
Conclusions: Cephalic vein vasoconstriction is a rare phenomenon associated with accessing the venous system during first-time CIED implantation. The propagation of CV constriction was limited by the location of the nearest valves.

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Keywords

cephalic vein; venous spasm; tunica media; venotomy; puncture; lead implantation; cardiac implantable electronic device

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About this article
Title

Vasoconstrictive responses of the cephalic vein during first-time cardiac implantable electronic device placement

Journal

Folia Morphologica

Issue

Vol 77, No 3 (2018)

Article type

Original article

Pages

464-470

Published online

2018-01-08

Page views

1676

Article views/downloads

806

DOI

10.5603/FM.a2018.0001

Pubmed

29345717

Bibliographic record

Folia Morphol 2018;77(3):464-470.

Keywords

cephalic vein
venous spasm
tunica media
venotomy
puncture
lead implantation
cardiac implantable electronic device

Authors

R. Steckiewicz
E. B. Świętoń
M. Bogdańska
P. Stolarz

References (13)
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