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Abstract:

Aim: was to evaluate the importance of pre-procedural cephalic vein (CV) angiography for pacemaker (PM) implantation better results.

Methods: 94 patients (pts) (55 women) aged 23-93 years old were included into the study Pts were randomized into two groups (1:1). Group I (n=47; 24 females): angiography of CV was made before PM implantation. In Group II PM implantation was performed without previously angiography Endpoints: time of procedure, efficacy doses

Results: fluoroscopy time and length of procedure in group I were less than in group II (p=0.0002 and p<0.0001 respectively). Four types of CV anatomy were found. Thus, I type of CV anatomy was most favorable for procedure due to angle between v.cephalica and subclavian vein less then 900. Conclusion: the acute angle of cephalic-axillary confluence is the most common type of CV anatomy and is associated with most success of procedure. Implantation of PM taking into consideration variants of anatomical structure of v cephalica in the subclavian area can reduce the radiation dose, possibility of complications, as well as reduce the duration of the intervention. Preoperative evaluation of the anatomical structure of veins of upper limbs before implantation of permanent pacemakers is a rational approach that allows choosing the method of conducting endocardial electrodes in the right heart.

 

 References

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11.    Chan N., Kwong N., Cheong A., et al. Venous access and long-term pacemaker lead failure: comparing contrast-guided axillary vein puncture with subclavian puncture and cephalic cutdown. Europace (2016), euw147.

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14.    Knight B., Curlett K., Oral H., et al. Clinical predictors of successful cephalic vein access for implantation of endocardial leads. J Interv Card Electrophysiol. 2002 Oct; 6 (2): 177-180.

 

Abstract:

This report touches upon the pressing problem of endocardial leads removal. It is essential to free the leads safely and effectively of fibrous depositions on contact points of venous walls or cardiac structures. Main principles of retrieval are contratraction and contra0 pressure. Authors present a comprehensive review of all existing lead removal techniques, from simple traction to active extraction device application, discussing clinical efficiency, indications and possible complications of each method. Active extraction systems are declared to be most advantageous.

 

References

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3.           Path   to   growth.   Cardiac   Lead   Removal System.  Spectranetics annual report  2004. Colorado Springs. 2005.

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6.           Byrd C.L. et al. Lead extraction: indications and   techniques. Cardiol. lin. 1992;   10: 735-748.

7.           Hayes D.L. Extraction of permanent pacing leads. There are still controversies in Editorial. Eur. Heart.J. 1996; 75 (6): 539.

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9.           Bellot P.H.  Introduction.  Endocardial lead extraction. A videotape and manual. Armonk. Futura. Pub. 1998; 3-11.

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14.       Bellot P.H. Endocardial Lead Extraction. In Cardiac pacing for the clinician. Eds. Kusumoto M., Goldschlager N.F. Springer. 2008; 280-281.

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