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Pacing Clin Electrophysiol 2022 Jun 18;45(6):717-725. Epub 2022 May 18.

Cardiology Department, Athens General Hospital "G. Gennimatas", Athens, Greece.

Objectives: Many of the complications arising from cardiac device implantation are associated to the venous access used for lead placement. Previous analyses reported that cephalic vein cutdown (CVC) is safer but less effective than subclavian vein puncture (SVP). However, comparisons between these techniques and axillary vein puncture (AVP) - guided either by ultrasound or fluoroscopy - are lacking. Read More

J Vet Emerg Crit Care (San Antonio) 2022 May 2;32(3):356-364. Epub 2022 Feb 2.

Hospital for Small Animals, The Royal (Dick) Veterinary School, The University of Edinburgh, Edinburgh, UK.

Objective: To compare the success rates and time taken to cannulate the jugular, cephalic, and lateral saphenous veins using a cutdown technique by personnel with 4 different levels of experience.

Design: Prospective ex vivo study.

Setting: Veterinary university teaching hospital. Read More

J Interv Card Electrophysiol 2022 Feb 2. Epub 2022 Feb 2.

University Witten/Herdecke, Witten, Germany.

Purpose: The cephalic vein cutdown (CVC) and the subclavian puncture (SP) is the most common access for pacemaker implantation. The purpose of this study was to compare the peri-/postoperative complications of these approaches.

Methods: A retrospective analysis of the quality assurance data of the state of North Rhine-Westphalia was performed to evaluate the peri-/postoperative complications of first pacemaker implantation according to the venous access. Read More

Europace 2022 04;24(4):697

Department of Clinical Medicine, Aarhus University, Aarhus N, Denmarkand.

Europace 2022 04;24(4):697

Evangelical Hospital Hagen-Haspe, Clinic for Cardiology and Electrophysiology, Brusebrinkstrasse 20, 58135 Hagen, Germany.

J Chin Med Assoc 2022 02;85(2):259-262

Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.

Total implantable venous access port (TIVAP) by cephalic vein cutdown (CVCD) is one of the first procedures surgery residents can be performed independently under supervision. There is currently a lack of affordable simulators for teaching and assessing TIVAP competency to improve patient safety. A panel of 10 experts divided the TIVAP by CVCD procedure into 9 steps. Read More

J Arrhythm 2021 Dec 26;37(6):1506-1511. Epub 2021 Sep 26.

Department of Cardiology Westmead Hospital Sydney New South Wales Australia.

We reviewed the different approaches used for central vein access during insertion of cardiac implantable electronic devices. The benefits and hazards of each approach (cephalic vein cutdown, axillary vein cannulation using venography and ultrasound) are discussed. Each approach has its advantages and hazards that need to be considered for the individual patient and balanced against the skills of the operator. Read More

J Cardiovasc Med (Hagerstown) 2021 04;22(4):237-245

Cardiology Division, Ospedale Provinciale AREA VASTA 3, Macerata, Italy.

The current narrative review provides an update of available knowledge on venous access techniques for cardiac implantable electronic device implantation, with a focus on axillary vein puncture. Lower procedure-related and lead-related complications have been reported with extrathoracic vein puncture techniques compared with intrathoracic accesses. In particular, extrathoracic lead access through the axillary vein seems to be associated with lower complication incidence than subclavian vein puncture and higher success rate than cephalic vein cutdown. Read More

Langenbecks Arch Surg 2021 May 7;406(3):903-910. Epub 2021 Feb 7.

Department of General, Visceral and Transplant Surgery, University Hospital Münster, Waldeyerstrasse 1, 48149, Münster, Germany.

Purpose: Modern oncological treatment algorithms require a central venous device in form of a totally implantable venous access port (TIVAP). While most commonly used techniques are surgical cutdown of the cephalic vein or percutaneous puncture of the subclavian vein, there are a relevant number of patients in which an additional strategy is needed. The aim of the current study is to present a surgical technique for TIVAP implantation via an open Seldinger approach of the internal jugular vein and to characterize risk factors, associated with primary failure as well as short- (< 30 days) and long-term (> 30 days) complications. Read More

Pneumologie 2020 Jun 17;74(6):371-373. Epub 2020 Jun 17.

Abteilung für Kardiologie, Rhythmologie und konservative Intensivmedizin, Augusta-Krankenhaus Düsseldorf, Akademisches Lehrkrankenhaus der Heinrich-Heine-Universität Düsseldorf.

History:  An 80-year old female was referred to our hospital with left internal carotid artery stenosis and a childhood history of hemoptysis.

Investigations And Diagnosis:  The ECG showed 2nd degree Mobitz atrio-ventricular block. The chest x-ray and computerized tomography identified a shift of the mediastinum and the heart to the left. Read More

JACC Clin Electrophysiol 2020 06 16;6(6):661-671. Epub 2020 Mar 16.

Kansas City Heart Rhythm Institute and Research Foundation, Kansas City, Kansas, USA.

Objectives: This study sought to evaluate the efficacy and safety of venous access techniques for cardiac implantable electronic device (CIED) implantation.

Background: Minimally invasive transvenous access is a fundamental step during implantation of CIEDs. However, the preferred venous access is still subject to ongoing debate, and the decision depends on patient characteristics and operator experience. Read More

Pacing Clin Electrophysiol 2020 07 3;43(7):713-719. Epub 2020 Jun 3.

Department of Surgery, Catholic University Hospital "A. Gemelli", Roma, Italy.

Background: The venous access for the insertion of permanent leads of cardiac implantable electronic devices is often achieved by venous cutdown of the cephalic vein, or by "blind" puncture of the subclavian vein using anatomical landmarks, or by fluoroscopy-assisted methods.

Methods: We have retrospectively analyzed our clinical experience to verify the feasibility, the safety, and efficacy of the adoption of ultrasound-guided puncture/cannulation of the axillary vein for this purpose.

Results: Nine hundred eighty-seven leads were placed during 548 consecutive procedures, accessing the axillary vein in the infraclavicular area using real-time ultrasound guidance. Read More

Anesthesiol Res Pract 2019 10;2019:6769506. Epub 2019 Dec 10.

Oslo University Hospital, Division of Emergencies and Critical Care, Department of Anaesthesiology, Postbox 4950 Nydalen, 0424 Oslo, Norway.

Background: Long-term venous access has become the standard practice for the administration of chemotherapy, fluid therapy, antibiotics, and parenteral nutrition. The most commonly used methods are percutaneous puncture of the subclavian and internal jugular veins using the Seldinger technique or surgical cutdown of the cephalic vein.

Methods: This study is based on a quality registry including all long-term central venous catheter insertion procedures performed in patients >18 years at our department during a five-year period. Read More

Am J Case Rep 2019 Oct 8;20:1482-1486. Epub 2019 Oct 8.

Division of Cardiovascular Medicine - Electrophysiology Section, Department of Medicine, SUNY (State University of New York) Downstate, Brooklyn, NY, USA.

BACKGROUND Cardiac implantable electronic devices (CIED) are mainstay therapy for a variety of patients with bradyarrhythmia as well as those at risk of sudden cardiac death and heart failure. At present, commonly used venous access are axillary, cephalic cutdown, and subclavian puncture. However, there are situations when these approaches cannot be employed because cannulation is not possible due to small size, spasm, absence, or occlusion of the vein. Read More

J Vasc Surg Venous Lymphat Disord 2019 11 5;7(6):865-869.e1. Epub 2019 Sep 5.

Division of Digestive Surgery, University Hospital of Geneva and Faculty of Medicine, Geneva, Switzerland.

Background: Surgical venous cutdown is a method for totally implantable venous access device (TIVAD) insertion. The main drawback of this technique is its higher failure rate when compared with the percutaneous approach, which is mostly related to anatomic variations of the cephalic vein. The aim of this study was to assess preoperative ultrasound imaging as a tool to predict cephalic vein cutdown failure for TIVAD insertion. Read More

Dtsch Med Wochenschr 2019 08 27;144(17):1209-1211. Epub 2019 Aug 27.

Abteilung für Kardiologie, Rhythmologie und konservative Intensivmedizin, Augusta-Krankenhaus Düsseldorf, Akademisches Lehrkrankenhaus der Heinrich-Heine-Universität Düsseldorf.

History: An 80-year old female was referred to our hospital with left internal carotid artery stenosis and a childhood history of hemoptysis.

Investigations And Diagnosis: The ECG showed 2nd degree Mobitz atrio-ventricular block. The chest x-ray and computerized tomography identified a shift of the mediastinum and the heart to the left. Read More

J Visc Surg 2019 Jun 29;156(3):239-243. Epub 2019 May 29.

Service de chirurgie digestive et endocrinienne, CHU de Bordeaux, Haut-Lévêque, avenue du Haut-Lévêque, 33600 Pessac, France.

Europace 2019 Jan;21(1):121-129

Division Clinical Electrophysiology, Department of Cardiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, Frankfurt am Main, Germany.

Aims: Cephalic vein cutdown (CVC) and subclavian puncture (SP) are widely used techniques for lead insertion of cardiac implantable electronic devices (CIEDs). Whether one technique is superior to the other, is still being debated. The purpose of this study was to compare CVC vs. Read More

Am Surg 2018 Jun;84(6):841-843

The request for totally implantable venous access devices (TIVADs) has rapidly grown up through the last decades. TIVADs are implanted by direct vein puncture or by surgical approach with vein cutdown. The authors present a comparative prospective study evaluating external jugular vein (EJV) and cephalic vein cutdown techniques. Read More

Indian Pacing Electrophysiol J 2018 Jul - Aug;18(4):152-154. Epub 2018 Apr 13.

Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan.

The cutdown technique for the cephalic vein is a common access route for transvenous cardiac device leads (TVLs), and sometimes one cephalic vein can accomodate two TVLs. We examined a novel ligation technique to balance the hemostasis and lead maneuverability for this two-in-one insertion. A total of 22 patients scheduled for cardiac device implantations with two or more leads were enrolled. Read More

Folia Morphol (Warsz) 2018;77(3):464-470. Epub 2018 Jan 18.

Department of Cardiology, Medical University of Warsaw, Poland, Banacha 1a, Warsaw, Poland.

Background: During cardiac implantable electronic device (CIED) implantation procedures cardiac leads have been mostly introduced transvenously. The associated injury to the selected vessel and adjacent tissues may induce reflex vasoconstriction. The aim of the study was to assess the incidence of cephalic vein (CV) vasoconstriction during first-time CIED implantation. Read More

Am Surg 2017 Dec;83(12):1336-1342

The superiority of surgical cut-down of the cephalic vein versus percutaneous catheterization of the subclavian vein for the insertion of totally implantable venous access devices (TIVADs) is debated. To compare the safety and efficacy of surgical cut-down versus percutaneous placement of TIVADs. This is a single-institution retrospective cohort study of oncologic patients who had TIVADs implanted by 14 surgeons. Read More

J Invasive Cardiol 2017 Dec;29(12):E184-E189

Director of Electrophysiology, NYU Winthrop Hospital, 212 Jericho Turnpike, Mineola, NY 11501 USA.

Objectives: The purpose of this study was to investigate the relationship between operator volume and implantable defibrillator lead failure and patient mortality at a single large implanting center.

Methods: This study analyzed the differences between high-volume and low-volume defibrillator implanters in the Pacemaker and Implantable Defibrillator Lead Survival Study ("PAIDLESS") between February 1, 1996 and December 31, 2011 at NYU Winthrop Hospital. "High-volume" was defined as performing ≥500 implants over the study period, while "low-volume" was defined as performing <500 implants. Read More

Folia Morphol (Warsz) 2016;75(4):543-549. Epub 2016 Nov 10.

Department of Cardiology, Medical University of Warsaw, Poland.

Background: The technique of axillary vein (AV) or subclavian vein (SV) puncture has become an important alternative to cephalic vein (CV) cutdown as an approach allowing cardiac lead introduction into the venous system during cardiac implantable electronic device (CIED) implantation procedures. Irrespective of the technique used, the injury associated with lead insertion may induce a reflex venous spasm that can even cause total venous obstruction. In order to assess the incidence of AV spasm during AV puncture, we analysed a total of 735 (382 in females and 353 in males; mean age 75 ± 11 years) de novo CIED implantation procedures involving transvenous lead insertion conducted between January 2014 and December 2015. Read More

Europace 2017 Jul;19(7):1193-1197

Alice Ho Miu Ling Nethersole Hospital, Hong Kong, People's Republic of China.

Aims: Existing data on the relationship between venous access and long-term pacemaker lead failure (PLF) are scarce and inconsistent. We aim to study the hypothesis that contrast-guided axillary vein puncture (AP) is better than subclavian puncture (SP) and similar to cephalic vein cutdown (CV) in the incidence of PLF and the success rate of AP is higher than CV.

Methods And Results: The case records of 409 patients with 681 implantable pacemaker leads were reviewed. Read More

Cochrane Database Syst Rev 2016 Aug 21(8):CD008942. Epub 2016 Aug 21.

Department of Medical Imaging, Princess Alexandra Hospital, 199 Ipswich Road, Brisbane, Queensland, Australia, 4102.

Background: Totally implantable venous access ports (TIVAPs) provide patients with a safe and permanent venous access, for instance in the administration of chemotherapy for oncology patients. There are several methods for TIVAP placement, and the optimal evidence-based method is unclear.

Objectives: To compare the efficacy and safety of three commonly used techniques for implanting TIVAPs: the venous cutdown technique, the Seldinger technique, and the modified Seldinger technique. Read More

J Surg Oncol 2016 Jan 8;113(1):114-9. Epub 2015 Dec 8.

Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan.

Background: The aims of this retrospective study, were to evaluate totally implantable central venous access device (TICVAD) implantation and to validate the efficacy of preoperative ultrasonography.

Methods: A total of 380 cases implanted with TICVADs were divided into four groups: cut-downs with ultrasonography (group A, n = 112); cut-downs without ultrasonography (group B, n = 37); venous puncture (group C, n = 122); and replacements using the existing catheter (group D, n = 109). Operation time, completion rate, and complications were compared. Read More

Folia Morphol (Warsz) 2015;74(4):458-64

Department of Cardiology, Medical University of Warsaw.

Background: Morphometric parameters of the venous vasculature constitute an important aspect in successful cardiac implantable electronic device (CIED) insertion. The purpose of this study was to present morpho-anatomical variations of the cephalic vein (CV) and their effect on the course of CIED implantation procedures, based on the patients from our centre.

Materials And Methods: We analysed contrast venography results obtained during first-time lead placement. Read More

Medicine (Baltimore) 2015 May;94(17):e728

From the Division of Thoracic and Cardiovascular Surgery (TWS, CFW, PJK, SYY, TCK, HCH, CYW), Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University; and Division of Chest and Critical care (JYF), Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Kweishan, Taoyuan, Taiwan.

An entry vessel is crucial for intravenous port implantation. A safe alternative entry vessel that can be easily explored is crucial for patients without feasible cephalic vein or for those who need port reimplantation because of disease relapse. In this study, we tried to analyze the safety and feasibility of catheter implantation via the deltoid branch of the thoracoacromial vein. Read More

Heart Rhythm 2015 Aug 23;12(8):1820-6. Epub 2015 Apr 23.

Referral Pacemaker Center, Clinical Center of Serbia, Belgrade, Serbia; University of Belgrade, School of Medicine, Belgrade, Serbia.

Background: Only a few studies on the cephalic vein cutdown technique for pacemaker lead implantation in children weighing ≤10 kg have been reported even though the procedure is widely accepted in adults.

Objective: The purpose of this study was to prove that cephalic vein cutdown for pacemaker lead implantation is a reliable technique with a low incidence of complications in children weighing ≤10 kg.

Methods: The study included 44 children weighing ≤10 kg with an endocardial pacemaker. Read More