Lu Wei-Da, Chen Ju-Yi
Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan.
Eur Heart J Case Rep. 2020 Jan 20;4(1):1-6. doi: 10.1093/ehjcr/ytz245. eCollection 2020 Feb.
Subclavian vein obstruction may occur in patients with pacemaker leads, which may make the implantation of new pacemaker leads difficult.
We report two cases in which upgrading to cardiac resynchronization therapy pacemaker was challenging due to total central vein occlusion. In the first case, a 78-year-old woman with permanent pacemaker implantation, 5 years ago, was successfully treated by balloon venoplasty. In the second case, balloon venoplasty was unsuccessful in a 46-year-old woman who has received twice single-chamber implantable cardioverter-defibrillator, 12 years and 5 years ago, due to vessel crowding, so a contralateral side puncture, along with a tunnel technique, was performed to solve this problem.
Cardiac implantable electronic device-related subclavian vein stenosis can present a challenge to common cardiac resynchronization therapy device upgrades in the absence of appropriate techniques.
起搏器导线患者可能发生锁骨下静脉阻塞，这可能会使新起搏器导线的植入变得困难。
我们报告两例因完全中心静脉闭塞而难以升级为心脏再同步治疗起搏器的病例。第一例，一名5年前植入永久性起搏器的78岁女性，通过球囊血管成形术成功治疗。第二例，一名46岁女性，分别在12年前和5年前接受过两次单腔植入式心脏复律除颤器治疗，由于血管拥挤，球囊血管成形术未成功，因此采用对侧穿刺并结合隧道技术解决了这一问题。
在缺乏适当技术的情况下，心脏植入式电子设备相关的锁骨下静脉狭窄可能会给普通的心脏再同步治疗设备升级带来挑战。
