Doppler-guided extrathoracic venipuncture of the lateral subclavian/axillary vein was successful for pacing lead insertion in 100% of 59 patients.
Observational (n=59)
No
Does Doppler-guided extrathoracic venipuncture allow for successful and safe placement of permanent pacing leads?
A simple Doppler flow detector is a highly successful and safe method for identifying the lateral subclavian/axillary vein for extrathoracic pacemaker lead placement.
Recent reports have raised concern over the use of standard subclavian puncture for placement of permanent pacing leads. This study reports the initial experience of one implanter in 59 consecutive, unselected patients undergoing implantation of a variety of pacing leads in whom a simple Doppler flow detector was used to guide extrathoracic venipuncture of the lateral subclavian/axillary vein. A total of 100 leads were placed for 48 right- and 11 left-sided systems. Lead insertion by this technique was successful in all patients. One small pneumothorax and two uncomplicated arterial punctures occurred. One patient's leads were revised electively because of unacceptable loss of redundancy when standing. There have been no infections or other late complications. A simple Doppler flow detector appears to be useful in identifying the lateral subclavian/axillary vein for extrathoracic pacemaker lead placement.
F. Earl Fyke (1995) conducted an observational in Implantation of permanent pacing leads (n=59). Doppler-guided extrathoracic venipuncture was evaluated on Successful lead insertion. Doppler-guided extrathoracic venipuncture of the lateral subclavian/axillary vein was successful for pacing lead insertion in 100% of 59 patients.