What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Patients scheduled for implantation of transvenous pacing or ICD leads (n=273). Intervention: Bilateral intravenous digital subtraction angiography (DSA). Primary outcome: Complete venous occlusion associated with developed collateral circulation.

What question did this study set out to answer?

To determine the prevalence of venous anatomic variants and venous occlusion, along with associated clinical risk factors, prior to transvenous lead implantation.

May 1, 2005Pacing and Clinical Electrophysiology

Prevalence of Venous Anatomic Variants and Occlusion Among Patients Undergoing Implantation of Transvenous Leads

Q: What are the key findings of this study?

Pre-procedural bilateral intravenous digital subtraction angiography revealed complete venous occlusion in 4.4% of patients scheduled for transvenous lead implantation.

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Key result

Pre-procedural DSA reveals complete venous occlusion in ~4% of patients scheduled for transvenous lead implantation.

n=273

Population

273 consecutive patients scheduled for implantation of transvenous pacing or ICD leads

Design

Cross-sectional

Authors

YOYasushi OginosawaHeart Rhythm Society HAHaruhiko AbeElectrophysiology YNYasuhide NakashimaOsaka City University

Discussion

Member takes

Implication

Pre-procedural venography may detect occult occlusions before lead placement; leaves open whether routine screening alters outcomes or complications.

Key Points

To determine the prevalence of venous anatomic variants and venous occlusion, along with associated clinical risk factors, prior to transvenous lead implantation.
Evaluated 273 consecutive patients scheduled for transvenous pacing or implantable cardioverter defibrillator lead implantation.
Assessed the venous anatomy of the arms, neck, and thorax prior to lead insertion using bilateral intravenous digital subtraction angiography.
Complete venous occlusion with collateral circulation occurred in 12 patients (4.4%), involving the left innominate vein (n=9), left subclavian vein (n=2), and right subclavian vein (n=1); 7 of these patients had prior surgical procedures.
Abnormal digital subtraction angiography findings were significantly more frequent on the left side than on the right side (P < 0.001), with persistent left superior vena cava detected in 1 patient (0.4%).
Cardio-thoracic ratio was significantly greater in patients with venous occlusions compared to patients with normal circulation (P = 0.012).

Study Design

Type

Cross-Sectional (n=273)

Structured PICO

Population

273 consecutive patients scheduled for implantation of transvenous pacing or ICD leads who underwent pre-procedural bilateral intravenous digital subtraction angiography.

Exposure

Bilateral intravenous digital subtraction angiography (DSA) prior to lead implantation

Outcome

Prevalence of venous anatomic variants and/or venous occlusionsurrogate

Asymptomatic venous abnormalities are present in 4.4% of patients requiring transvenous pacing leads, highlighting the need for careful evaluation, especially on the left side or in patients with increased cardio-thoracic ratio or prior central venous catheter.

Cite This Study

Oginosawa et al. (2005) conducted a cross-sectional in Patients scheduled for implantation of transvenous pacing or ICD leads (n=273). Bilateral intravenous digital subtraction angiography (DSA) was evaluated on Complete venous occlusion associated with developed collateral circulation. Pre-procedural bilateral intravenous digital subtraction angiography revealed complete venous occlusion in 4.4% of patients scheduled for transvenous lead implantation.

synapsesocial.com/papers/6aa26cf5275a83935b322dfe https://doi.org/10.1111/j.1540-8159.2005.09534.x

Topics

Cardiac device therapy

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Implication

Pre-procedural venography may detect occult occlusions before lead placement; leaves open whether routine screening alters outcomes or complications.

Prevalence of Venous Anatomic Variants and Occlusion Among Patients Undergoing Implantation of Transvenous Leads

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Prevalence of Venous Anatomic Variants and Occlusion Among Patients Undergoing Implantation of Transvenous Leads

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider