Key result
Biventricular implantable cardioverter defibrillator placement with lead insertion through the left internal jugular vein was feasible in a patient with extensive venous occlusion.
Why the study?
Vein stenosis or occlusion from long-term chronic hemodialysis in patients with end-stage renal failure poses challenges for coronary sinus lead placement, making alternative access like the left internal jugular vein necessary.
Case Report (n=1)
The left internal jugular vein can serve as a feasible alternative route for CRT-D lead placement in patients with extensive venous occlusion.
Answers are grounded in this paper and cite their sources.
May offer alternative access in venous occlusion; hypothesis-generating and should not yet change practice.
Placement of coronary sinus (CS) leads is predominantly accomplished via the left cephalic-axillary-subclavian venous system. However, vein stenosis or occlusion from long-term chronic hemodialysis (HD) in patients with end-stage renal failure can pose a challenge. Cannulation of the CS via the left internal jugular vein (IJV) is technically difficult but often feasible. We report a case in which a patient with end-stage renal disease (ESRD) had extensive left venous system occlusion from prior in dwelling HD catheters, and an AV fistula contralaterally, who underwent biventricular implantable cardioverter defibrillator placement with lead insertion through the left IJV.
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Manongi et al. (2022) conducted a case report in End-stage renal disease with extensive left venous system occlusion requiring CRT-D (n=1). Biventricular implantable cardioverter defibrillator placement with lead insertion through the left internal jugular vein was evaluated. Biventricular implantable cardioverter defibrillator placement with lead insertion through the left internal jugular vein was feasible in a patient with extensive venous occlusion.
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