Variations of Cephalic Vein Venography Performed Prior to an Antiarrhythmic Device Implantation

概要

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Background: We sometimes encounter difficulties in lead implantation using cephalic vein (CV) cut down technique due to kink. CV venography is helpful in such cases. Methods: In 67 right and 125 left CV venographies obtained from 180 patients (mean: 75 year-old, 88 males), variations, differences between both side and success rate in lead implantation were studied. Results: The CV ran smoothly into the subclavian vein (SV) in 72% in the right and 44% in the left, and leads were successfully implanted in 93%. Strong kink in the CV was found in 15% in the right and 34% in the left, and success rate in lead implantation was lower (77%) although a guide wire and sheath were employed. The CV was invisible in 13% in the right and 22% in the left. PLSVC was found in 2, and the SV obstructed in 1 in the left. Overall success rate in leads implantation by CV cut down technique was higher in the right side (84 vs 73%). Conclusion: Strong kink which may interfere in lead manipulation was found less frequently in the right CV, and higher success rate in lead implantation by CV cut down technique was expected in the right side.