Heart rhythm · 2010
Subclavian venoplasty by the implanting physicians in 373 patients over 11 years.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Worley Seth Joseph, Gohn Douglas Charles, Pulliam Robert Ward, Raifsnider Mandy A, Ebersole Benjamin I, Tuzi Joann
Аннотация
BACKGROUND: The need to add a lead(s) despite subclavian/innominate obstruction is increasing. Subclavian venoplasty may be a good alternative to the commonly employed options; however, there are few reports in the literature, and all are by interventional radiologists.
OBJECTIVE: To describe the procedural details, results and safety of venoplasty by implanting physicians in a large group of consecutive patients.
METHODS: Safety, lead function and success were established from review of the procedure reports and clinical complications in 373 consecutive venoplasty patients from 1999-2010. Procedural details were obtained by review of the angiograms (venograms) and procedural flow charts of 152 consecutive patients from 2004-2007.
RESULTS: Venoplasty was successful in 371 of 373 patients without damage to the existing leads and without clinical complications. Total angiographic occlusion was demonstrated in 65% of cases by peripheral venogram, but in only 20% of cases by contrast injection at the site of obstruction; 86% were crossed with a hydrophilic wire. Microdissection and excimer laser were used to cross three of the four wire-refractory occlusions. Obstruction was both central and peripheral in 22.1% of cases and central only in 17%. The time required to cross the obstruction and perform venoplasty was 13 ± 21 minutes. A noncompliant balloon was successful in most, but an ultranoncompliant balloon was required in 13% of cases. Contrast extravasation was common during crossing of a total obstruction and also was observed with balloon rupture on three occasions, but was not clinically significant.
CONCLUSIONS: Subclavian venoplasty is a safe, practical lead-management option that can be used by implanting physicians.
OBJECTIVE: To describe the procedural details, results and safety of venoplasty by implanting physicians in a large group of consecutive patients.
METHODS: Safety, lead function and success were established from review of the procedure reports and clinical complications in 373 consecutive venoplasty patients from 1999-2010. Procedural details were obtained by review of the angiograms (venograms) and procedural flow charts of 152 consecutive patients from 2004-2007.
RESULTS: Venoplasty was successful in 371 of 373 patients without damage to the existing leads and without clinical complications. Total angiographic occlusion was demonstrated in 65% of cases by peripheral venogram, but in only 20% of cases by contrast injection at the site of obstruction; 86% were crossed with a hydrophilic wire. Microdissection and excimer laser were used to cross three of the four wire-refractory occlusions. Obstruction was both central and peripheral in 22.1% of cases and central only in 17%. The time required to cross the obstruction and perform venoplasty was 13 ± 21 minutes. A noncompliant balloon was successful in most, but an ultranoncompliant balloon was required in 13% of cases. Contrast extravasation was common during crossing of a total obstruction and also was observed with balloon rupture on three occasions, but was not clinically significant.
CONCLUSIONS: Subclavian venoplasty is a safe, practical lead-management option that can be used by implanting physicians.