title: Femoral approach: an exceptional alternative for permanent pacemaker implantation.
abstract: The classic transvenous implantation of a permanent pacemaker in a pectoral location may be precluded by obstruction of venous access through the superior vena cava or recent infection at the implant site. When these barriers to the procedure are bilateral and there are also contraindications or technical difficulties to performing a thoracotomy for an epicardial approach, the femoral vein, although rarely used, can be a viable alternative. We describe the case of a patient with occlusion of both subclavian veins and a high risk for mini-thoracotomy or videothoracoscopy, who underwent implantation of a permanent single-chamber pacemaker via the right femoral vein.
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal. Electronic address: brunovalente4@hotmail.com.
authors.forename: Bruno
authors.initials: B
authors.lastname: Tereno Valente
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
authors.forename: José M
authors.initials: JM
authors.lastname: Conceição
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
authors.forename: Manuel
authors.initials: M
authors.lastname: Nogueira da Silva
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
authors.forename: Mário
authors.initials: M
authors.lastname: M Oliveira
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: S Cunha
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Lousinha
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Galrinho
authors.affiliation: Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: C Ferreira
mesh_terms: D005260:Female; D005268:Femoral Vein; D006801:Humans; D008875:Middle Aged; D010138:Pacemaker, Artificial; D019919:Prosthesis Implantation / Q000379:methods
keywords: Implantation via femoral vein; Implantação via veia femoral; Obstrução acessos venosos; Pacing cardíaco definitivo; Permanent cardiac pacing; Radioterapia; Radiotherapy; Venous access occlusion