Key result
Implant venoplasty using balloon dilation is outlined as a method to facilitate device implantation in patients with subclavian vein obstruction or small coronary veins.
This article provides a practical overview of implant venoplasty techniques to overcome subclavian and coronary vein obstructions during cardiac device implantation.
May facilitate device implantation in obstructed veins; leaves open need for prospective outcome data before routine adoption.
Subclavian vein (SV) obstruction occurs in 13-35% of patients with prior leads, resulting in use of proximal venous access, the other vein, laser lead extraction, or surgery. Surgery is required for optimal left ventricle lead placement in 10-15% of cardiac resynchronization therapy candidates because of small or stenotic veins. Published data describe the safe and successful balloon dilation of both subclavian and coronary veins (CV); however, implant venoplasty is rarely performed because many implanting physicians are not familiar with the use of balloons. This article outlines how we use venoplasty to facilitate implantation in our laboratory. The indications, frequency, observed and potential complications that have evolved with our experience are also discussed.
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Seth J. Worley (2008) conducted a review in Subclavian vein obstruction or small/stenotic coronary veins in patients requiring device implantation. Implant venoplasty (balloon dilation of subclavian and coronary veins) was evaluated. Implant venoplasty using balloon dilation is outlined as a method to facilitate device implantation in patients with subclavian vein obstruction or small coronary veins.
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