Key result
Needle recanalization enables successful dual-chamber pacemaker lead placement across chronic subclavian vein occlusion.
Why the study?
Complete chronic subclavian vein occlusion usually prevents using that vein for pacemaker lead placement, but alternative transvenous access methods may be possible.
Case Report (n=1)
Demonstrates the feasibility of transvenous pacemaker lead placement through an introducer in patients with chronic subclavian vein occlusion if a patent segment exists beyond the obstruction.
Answers are grounded in this paper and cite their sources.
May support lead placement in select subclavian occlusions with distal patency; leaves open generalizability and safety in larger cohorts.
Under ordinary circumstances complete chronic subclavian vein occlusion precludes using that vein for the pacemaker lead. There are circumstances, however, in which a patent vein beyond the obstruction can be reached with an introducer needle, thus permitting transvenous access similar to any other introducer-assisted implantation. A case exemplifying this point is described. Patency of the right subclavian vein beyond an occlusion was demonstrated by angiography, and a new dual-chamber pacemaker lead was inserted through that site by use of the introducer method.
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Parsonnet et al. (1991) conducted a case report in Chronic subclavian vein occlusion requiring pacemaker lead insertion (n=1). Transvenous placement of a pacemaker lead through an introducer needle was evaluated on Successful insertion of a dual-chamber pacemaker lead. Transvenous placement of a dual-chamber pacemaker lead was successfully achieved using an introducer needle to access a patent vein beyond a chronic subclavian vein occlusion.
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