Abstract
Introduction: The obtaining of venous access for implantation of implantable electronic cardiac devices (IECDs) has been traditionally made by intrathoracic subclavian vein puncture (SVP) or cephalic vein phlebotomy (CVP). Evidence indicates, however, the increased risk of short-term and long-term complications with SVP due to the fact that it is intrathoracic access and the risk of compression of the electrodes by the costoclavicular ligament, leading to different types of defects. CVP, in turn, has been associated with a failure rate that reaches 45%. Axillary vein puncture (AVP) has been described in the literature and is presented here as an alternative to the two techniques mentioned. Methods: A PubMed survey was conducted on articles that mention the AVP, SVP and CVP techniques and compare them to the immediate, short and long term results and success rates for obtaining venous access. Emphasis was placed on comparisons between the various AVP techniques. Conclusion: The AVP technique for obtaining venous access presents some variations among the different authors. It has CVP-like safety, success rates comparable to those of the subclavian vein, and better medium and long term results for electrode function.
Highlights
The obtaining of venous access for implantation of implantable electronic cardiac devices (IECDs) has been traditionally made by intrathoracic subclavian vein puncture (SVP) or cephalic vein phlebotomy (CVP)
Obtaining venous access by the intrathoracic subclavian can be justified by the premise that the best way to do a procedure is to do the way one has the most experience
Several data have shown that other forms of venous access with punctures that access the vascular bed in an extrathoracic location, such as Axillary vein puncture (AVP), may be equal or easier, safer, and present a lower risk of short- and long-term complications[19,20,21,22,23,24]
Summary
The obtaining of venous access for implantation of implantable electronic cardiac devices (IECDs) has been traditionally made by intrathoracic subclavian vein puncture (SVP) or cephalic vein phlebotomy (CVP). Methods: A PubMed survey was conducted on articles that mention the AVP, SVP and CVP techniques and compare them to the immediate, short and long term results and success rates for obtaining venous access. Conclusion: The AVP technique for obtaining venous access presents some variations among the different authors It has CVP-like safety, success rates comparable to those of the subclavian vein, and better medium and long term results for electrode function. Introdução: A obtenção do acesso venoso para implante de dispositivos cardíacos eletrônicos implantáveis (DCEIs) tem sido tradicionalmente feita por meio da punção da veia subclávia intratorácica (PVS) ou por flebotomia da veia cefálica (FVC). Métodos: Realizou-se uma pesquisa pelo PubMed sobre artigos que mencionam as técnicas de PVA, PVS e FVC e que as comparam quanto aos resultados imediatos, a curto e longo prazos e taxas de sucesso para a obtenção do acesso venoso. PALAVRAS-CHAVE: Punção da veia axilar; Flebotomia da veia cefálica; Punção da veia subclávia; Complicações com implante de marcapassos
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