Pre-procedure duplex ultrasonography to assist cephalic vein isolation in pacemaker and defibrillator implantation

中國醫藥大學機構典藏 China Medical University Repository, Taiwan > 台中附設醫院 > 會議論文 > Item 310903500/27173

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题名:	Pre-procedure duplex ultrasonography to assist cephalic vein isolation in pacemaker and defibrillator implantation
作者:	Chen, JY;Chang, KC;Lin, YC;Chou, HT;Hung, JS
贡献者:	附設醫院內科部心臟科 China Med Univ Hosp, Div Cardiol, Dept Med, Taichung, Taiwan
日期:	2005
上传时间:	2010-09-20 13:55:17 (UTC+8)
出版者:	SPRINGER
摘要:	Background: Difficulty in isolating the cephalic vein contributes to failed pacemaker and intracardiac cardioverter-defibrillator (ICD) implantation via the cephalic venous approach. The deltopectoral groove is used as a rough landmark, but the vein is often not found here. We evaluated the benefit of pre-procedural duplex ultrasonography in isolating the cephalic vein. Methods: We enrolled 80 consecutive patients undergoing new pacemaker or defibrillator implantation and performed duplex ultrasonography to localize the cephalic vein before implantation. The corresponding surface location in the infraclavicular region and the depth of the cephalic vein were identified and recorded if the vein was well visualized. Using the imaging results, we dissected the skin over the predicted location until the cephalic vein was isolated. We determined the depth and corresponding surface location of the proximal cephalic vein during surgery. Afterward, we compared localization of the vein using imaging, surgery, and the deltopectoral-groove method. The relationship between cephalic vein depth and body parameters was also evaluated after the procedure. Results: All proximal cephalic veins were successfully isolated under the assistance of pre-procedural duplex ultrasonography. When the corresponding surface locations were compared, the location depicted on sonograms was closer to the surgical finding than the location determined by using the deltopectoral-groove method (0.5 +/- 3.9 vs. 4.9 +/- 9.6 mm; P <.001). The depth of the cephalic vein derived from duplex sonograms showed excellent correlation with the surgical findings (r = 0.93, P < 0.001). The cephalic vein depth and body mass index (BMI) also showed a linear relationship with good correlation (r = 0.70, P < 0.001). Conclusion: Pre-procedural duplex ultrasonography helped in localizing the proximal cephalic vein and isolating the cephalic vein. Surface localization of the proximal cephalic vein was superior with sonography than with the deltopectoral-groove method. There was a linear relationship with good correlation between BMI and cephalic vein depth.
關聯:	JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY 12(1):75-81
显示于类别:	[台中附設醫院] 會議論文

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