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经颈静脉塞丁格技术在高龄上肢静脉系统难以穿刺患者永久起搏器植入术中的应用

Transjugular Seldinger approach for permanent pacemaker implantation in octogenarian with inaccessible upper limbs venous system.

作者信息

Tondas Alexander Edo, Mulawarman Rido, Trifitriana Monica, Abisha Savero Evan, Pranata Raymond

机构信息

Department of Cardiology and Vascular Medicine Mohammad Hoesin General Hospital Palembang Sumatera Selatan Indonesia.

Biomedicine Doctoral Program Faculty of Medicine Universitas Sriwijaya Palembang Indonesia.

出版信息

J Arrhythm. 2019 Dec 16;36(1):199-202. doi: 10.1002/joa3.12287. eCollection 2020 Feb.

DOI:10.1002/joa3.12287
PMID:32071646
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7011814/
Abstract

In up to 13.7% of device implants, lead entry through the cephalic, axillary, or subclavian veins might be unfeasible. Transjugular permanent pacemaker (PPM) implantation may be considered as a bailout strategy in the difficult anatomy of conventional veins, before resorting to epicardial pacing lead, which requires general anesthesia and thoracotomy. We described a case report of a single chamber PPM implantation in an 83-year-old man using transjugular Seldinger approach without surgical cut down of the internal jugular vein, due to spasm, stenosis, and thrombosis of the upper limbs venous systems. Acceptable lead impedance and threshold were maintained during 2 months follow-up.

摘要

在高达13.7%的设备植入病例中，经头静脉、腋静脉或锁骨下静脉置入导线可能不可行。在采用需要全身麻醉和开胸手术的心外膜起搏导线之前，经颈静脉永久起搏器（PPM）植入可被视为常规静脉解剖结构复杂时的一种补救策略。我们报告了一例83岁男性患者，因上肢静脉系统痉挛、狭窄和血栓形成，采用经颈静脉Seldinger技术进行单腔PPM植入，未进行颈内静脉的外科切开。在2个月的随访期间，导线阻抗和阈值保持在可接受范围内。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24a3/7011814/c2290e6b748f/JOA3-36-199-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24a3/7011814/0ea2bf4ad8df/JOA3-36-199-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24a3/7011814/c2290e6b748f/JOA3-36-199-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24a3/7011814/0ea2bf4ad8df/JOA3-36-199-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24a3/7011814/c2290e6b748f/JOA3-36-199-g002.jpg

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Transjugular Seldinger approach for permanent pacemaker implantation in octogenarian with inaccessible upper limbs venous system.经颈静脉塞丁格技术在高龄上肢静脉系统难以穿刺患者永久起搏器植入术中的应用
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本文引用的文献

1
Permanent pacing in patients without upper limb venous access: a review of current techniques.无上肢静脉通路患者的永久性起搏：当前技术综述
Heart Asia. 2014 Nov 27;6(1):163-6. doi: 10.1136/heartasia-2014-010546. eCollection 2014.
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Warfarin prevents venous obstruction after cardiac devices implantation in high-risk patients: partial analysis.华法林可预防高危患者心脏装置植入术后的静脉阻塞：部分分析
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The incidence and risk factors for venous obstruction after implantation of transvenous pacing leads.
经静脉起搏导线植入术后静脉阻塞的发生率及危险因素。
Pacing Clin Electrophysiol. 2002 Nov;25(11):1605-11. doi: 10.1046/j.1460-9592.2002.01605.x.
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Pacemaker implantation through the internal jugular vein.经颈内静脉植入起搏器。
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Iliac vein approach to permanent pacemaker implantation.
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