Felix Yang1, Guy Kulbak2. 1. Department of Cardiology, Maimonides Medical Center, 4802 10th Ave, Brooklyn, NY 11219, USA fyang@maimonidesmed.org. 2. Department of Cardiology, Maimonides Medical Center, 4802 10th Ave, Brooklyn, NY 11219, USA.
Abstract
AIMS: The axillary vein is frequently used to implant pacemaker and defibrillator leads. We describe a technique utilizing the caudal fluoroscopic view to facilitate axillary venous access without contrast. METHODS AND RESULTS: Outcomes of device implants or upgrades utilizing this technique were examined during a 1-year period at our institution. Of 229 consecutive implants, only 9 patients required an alternate technique for lead implantation. There were zero cases of pneumothorax. CONCLUSIONS: The caudal view allows for optimal appreciation of the anterior border of the lung and the first rib. This simple technique increases the implanter's appreciation of and control over the access needle depth relative to the lung and first rib, thereby reducing pneumothorax risk. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: The axillary vein is frequently used to implant pacemaker and defibrillator leads. We describe a technique utilizing the caudal fluoroscopic view to facilitate axillary venous access without contrast. METHODS AND RESULTS: Outcomes of device implants or upgrades utilizing this technique were examined during a 1-year period at our institution. Of 229 consecutive implants, only 9 patients required an alternate technique for lead implantation. There were zero cases of pneumothorax. CONCLUSIONS: The caudal view allows for optimal appreciation of the anterior border of the lung and the first rib. This simple technique increases the implanter's appreciation of and control over the access needle depth relative to the lung and first rib, thereby reducing pneumothorax risk. Published on behalf of the European Society of Cardiology. All rights reserved.