Key result
Multiple femoral venous sheath placement resulted in a 19.2% incidence of nonocclusive deep vein thrombosis, which was not significantly different from the 9.1% incidence observed with single sheath placement (p=0.52), and most thrombi regressed spontaneously within 1 week.
Why the study?
Does short-term multiple venous sheath placement in a single femoral vein increase the risk of deep vein thrombosis or vascular complications compared to single sheath placement in patients undergoing EPS or RF ablation?
Observational (n=52)
No
Does short-term multiple venous sheath placement in a single femoral vein increase the risk of deep vein thrombosis or vascular complications compared to single sheath placement in patients undergoing EPS or RF ablation?
Absolute Event Rate: 19.2% vs 9.1%
p-value: p=0.52
Short-term placement of multiple venous sheaths in a single femoral vein during EP procedures is relatively safe, with nonocclusive DVT occurring frequently but typically regressing spontaneously within a week.
May support multiple femoral sheaths during EP procedures; leaves open need for randomized confirmation of safety.
Multiple intracardiac catheters are often necessary for electrophysiological study (EPS) and radiofrequency (RF) ablation therapy. Therefore, multiple venous sheath placement in one femoral vein is always required for multiple intracardiac catheter insertion. The vascular complications incurred by placement of multiple sheaths have not been fully studied. We utilized duplex ultrasonography to assess the femoral veins before and after the procedure. This study consisted of 52 patients (68 femoral veins) who underwent EPS and RF ablation therapy. Up to three sheaths were inserted into a single femoral vein. Nonocclusive deep vein thrombosis (DVT) occurred in 12/68 veins (17.6%) of 11 patients on the day following the procedure. Thrombosis regressed spontaneously in 11 veins and persisted in 1 vein at 1-week follow-up. The venous diameter significantly decreased the day after the procedure (8.7 +/- 1.2 mm vs 5.3 +/- 1.5 mm, P < 0.001), but recovered by the 1-week follow-up (7.9 +/- 1.7 mm, P = 0.07) in the 12 veins. Short-term placement of multiple venous sheaths in a single femoral vein appears to be safe. Nonetheless, nonocclusive DVT does occur in a significant number of patients. Although thrombosis regressed and the outcome appeared to be benign in most patients, close follow-up to avoid potential vascular complications is necessary.
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Chen et al. (2004) conducted an observational in Cardiac arrhythmias requiring electrophysiological study and radiofrequency catheter ablation (n=52). Multiple femoral venous sheath placement vs. Single femoral venous sheath placement was evaluated on Non-occlusive deep vein thrombosis (DVT) (p=0.52). Multiple femoral venous sheath placement resulted in a 19.2% incidence of nonocclusive deep vein thrombosis, which was not significantly different from the 9.1% incidence observed with single sheath placement (p=0.52), and most thrombi regressed spontaneously within 1 week.
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