Key result
Passing a hydrophilic wire from the superior vena cava through collaterals to the infraclavicular region successfully enabled venous access for ICD implantation despite bilateral venous obstruction.
Demonstrates a novel technique for obtaining venous access for ICD implantation in patients with bilateral upper extremity venous obstruction.
May enable bailout access in bilateral obstruction; leaves open safety, reproducibility, and broader applicability.
Placing an implantable cardioverter-defibrillator is a challenge in the presence of bilateral venous obstruction of the upper extremities. We describe a case where venous access was obtained by passing a hydrophilic wire from the superior vena cava through collaterals to the infraclavicular region.
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Ranjan et al. (2009) studied this question. Passing a hydrophilic wire from the superior vena cava through collaterals to the infraclavicular region successfully enabled venous access for ICD implantation despite bilateral venous obstruction.
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