Cardiovascular Diseases & Diagnosis

Contrast-Filled Balloon Guided Needle Puncturing in the Presence of Ipsilateral Subclavian Vein Occlusion

Abstract

Sharifkazemi M, Rezaian G and Sayyad M

Aim: The purpose of this report is to convey our experience with the use of the new technique for the safe needle puncturing in the subclavian or brachiocephalic vein in patients with ipsilateral venous obstruction.
Methods: In the time period from June 2016 to June 2018, eleven patients who were candidates for implantation or upgrading of cardiac implantable electronic devices enrolled to do this technique; all patients which were showed to have subclavian vein obstruction through ipsilateral phlebography. By introducing the guiding catheter from femoral vein into the brachiocephalic vein, doing retrograde brachiocephalic venography, followed by passing of the guidewire, the over the wire balloon tracked the guidewire and was placed in a proper location.
Results: The balloon filled with contrast and worked as a landmark for needle puncturing. Between one to three attempts needle puncturing were performed to get to the vein successfully. Then, the valve peel away sheath(s) was/were indwelled over the anterograde guidewire that introduce through the needle and finally the lead(s) was/ were placed in the standard fashion. There were no complications at all and the procedure prevented time wasting.
Conclusion: Contrast-filled balloon guided needle puncturing technique in the presence of ipsilateral subclavian vein obstruction is a safe and feasible method.