Why the study?
Does subclavian venoplasty improve the quality of venous access compared to dilators in patients with subclavian obstruction requiring lead implantation?
Does subclavian venoplasty improve the quality of venous access compared to dilators in patients with subclavian obstruction requiring lead implantation?
Subclavian venoplasty is highlighted as a safe, effective, and superior alternative to dilators for overcoming subclavian obstruction during cardiac device lead addition or replacement.
May facilitate lead implantation in subclavian obstruction; hypothesis-generating and should not yet change practice.
Subclavian obstruction is common after lead implantation and the need to add or replace a lead is increasing. Subclavian venoplasty (SV) is a safe and effective option for venous occlusion. Peripheral venography overestimates the severity of the obstruction. A wire can usually be advanced into the central circulation for SV. Compared with dilators, SV improves the quality of venous access, providing unrestricted catheter manipulation for His bundle pacing and left ventricular lead implantation. SV preserves venous access and reduces lead burden. SV can easily be added to the implanting physicians lead management options.
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Marcial et al. (2018) studied this question.
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