title: Spontaneous subclavian venous occlusion before electronic device implantation.
abstract: BACKGROUND
  Subclavian venous occlusion sometimes precludes the ability to insert leads during placement of a cardiac implantable electronic device. This study was performed to identify the risk factors for spontaneous subclavian venous occlusion prior to placement of an implantable electronic device.
  
  
  METHODS
  We studied 446 patients who underwent axillary-subclavian venography to assess for occlusion and/or anomaly of the subclavian vein or associated veins before electronic device implantation.
  
  
  RESULTS
  Six (1.3%) patients had venous occlusion (left subclavian vein in 5, left innominate vein in 1). There was a significantly higher incidence of previous cancer in the occlusion group than in the nonocclusion group (11.5% vs. 50%, p = 0.03).
  
  
  CONCLUSIONS
  Subclavian venous occlusion may be present before cardiac implantable electronic device placement. A history of cancer represents a risk factor subclavian venous occlusion, and patients with this risk factor should undergo subclavian venography prior to electronic device placement.
authors.affiliation: Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kodani
authors.affiliation: Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, Nishinomiya, Japan mine@hyo-med.ac.jp.
authors.forename: Takanao
authors.initials: T
authors.lastname: Mine
authors.affiliation: Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kishima
authors.affiliation: Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Kenki
authors.initials: K
authors.lastname: Ashida
authors.affiliation: Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Masuyama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004869:Equipment Safety / Q000295:instrumentation*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009369:Neoplasms / Q000150:complications*; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D010690:Phlebography; D012307:Risk Factors; D013350:Subclavian Vein / Q000000981:diagnostic imaging*; D013997:Time Factors; D014689:Venous Insufficiency / Q000209:etiology*
keywords: Defibrillators; Neoplasms; Pacemaker; Subclavian vein; Venous thrombosis; artificial; implantable