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Original article
Published online: 2020-06-22
Submitted: 2020-01-10
Accepted: 2020-05-28
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Types of left brachiocephalic vein aberrations detected during cardiac implantable electronic device implantation procedures

R. Steckiewicz, P. Stolarz, E. B. Świętoń
DOI: 10.5603/FM.a2020.0069
·
Pubmed: 32639573

open access

Ahead of Print
ORIGINAL ARTICLES
Published online: 2020-06-22
Submitted: 2020-01-10
Accepted: 2020-05-28

Abstract

Background: Cardiac implantable electronic device (CIED) implantation procedures with transvenous lead placement afford an opportunity to observe vascular anatomic variations. The course of CIED implantation depends largely on morphometric and topographic characteristics of the relevant brachiocephalic vein (BCV), which is the left BCV in the case of lead insertion via the left clavipectoral triangle. This study aims to present left BCV anomalies arising from abnormal systemic vein embryogenesis and encountered during CIED implantation. Materials and methods: Venograms obtained during CIED implantation procedures and illustrating left BCV topography/morphometry were analyzed retrospectively for two types of anomalies: anomalies of the left BCV itself (data from the period 2014–2018) and a combination of left BCV variations with a persistent left superior vena cava (PLSVC); since the latter instances are rare, the analyzed period was longer (2003–2018). Results: Analysis of data from the first, 5-year-long, period included data from a group of 1,812 patients and revealed 5 cases (0.3%) of developmental left-BCV anomalies (3 double left BCV and 2 cases of a single subaortic left BCV). The 16-year long analyzed period included 6,110 CIED implantation procedures, which showed 12 cases of PLSVC (0.2%) including 4 cases (33%) of left BCV agenesis. Conclusions: The analyzed venograms rarely showed isolated left-BCV aberrations (0.3%), with the combination of left-BCV agenesis and PLSVC being much more common (33%). The morphometry and/or topography of aberrant left-BCV may result in difficulties during cardiac lead insertion.

Abstract

Background: Cardiac implantable electronic device (CIED) implantation procedures with transvenous lead placement afford an opportunity to observe vascular anatomic variations. The course of CIED implantation depends largely on morphometric and topographic characteristics of the relevant brachiocephalic vein (BCV), which is the left BCV in the case of lead insertion via the left clavipectoral triangle. This study aims to present left BCV anomalies arising from abnormal systemic vein embryogenesis and encountered during CIED implantation. Materials and methods: Venograms obtained during CIED implantation procedures and illustrating left BCV topography/morphometry were analyzed retrospectively for two types of anomalies: anomalies of the left BCV itself (data from the period 2014–2018) and a combination of left BCV variations with a persistent left superior vena cava (PLSVC); since the latter instances are rare, the analyzed period was longer (2003–2018). Results: Analysis of data from the first, 5-year-long, period included data from a group of 1,812 patients and revealed 5 cases (0.3%) of developmental left-BCV anomalies (3 double left BCV and 2 cases of a single subaortic left BCV). The 16-year long analyzed period included 6,110 CIED implantation procedures, which showed 12 cases of PLSVC (0.2%) including 4 cases (33%) of left BCV agenesis. Conclusions: The analyzed venograms rarely showed isolated left-BCV aberrations (0.3%), with the combination of left-BCV agenesis and PLSVC being much more common (33%). The morphometry and/or topography of aberrant left-BCV may result in difficulties during cardiac lead insertion.

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Keywords

aberrant left brachiocephalic vein, persistent left superior vena cava, venography, lead implantation, CIED

About this article
Title

Types of left brachiocephalic vein aberrations detected during cardiac implantable electronic device implantation procedures

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Original article

Published online

2020-06-22

DOI

10.5603/FM.a2020.0069

Pubmed

32639573

Keywords

aberrant left brachiocephalic vein
persistent left superior vena cava
venography
lead implantation
CIED

Authors

R. Steckiewicz
P. Stolarz
E. B. Świętoń

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