Implant venoplasty: dilation of subclavian and coronary veins to facilitate device implantation: indications, frequency, methods, and complications.
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.
Interventional Implant Program, The Heart Center, Lancaster General Hospital, The Lancaster Heart and Stroke Foundation, Lancaster, Pennsylvania 17603, USA. seth@mcworley.com
Seth J
SJ
Worley
D001807:Blood Vessel Prosthesis; D002404:Catheterization / Q000295:instrumentation* / Q000379:methods*; D003331:Coronary Vessels / Q000601:surgery*; D006801:Humans; D019919:Prosthesis Implantation / Q000295:instrumentation* / Q000379:methods*; D013350:Subclavian Vein / Q000601:surgery*; D020246:Venous Thrombosis / Q000601:surgery*