Ohta T, Okumura S, Fujioka M
Department of Thoracic Cardiovascular Surgery, Mimihara General Hospital, Osaka, Japan.
Kyobu Geka. 1994 Apr;47(4):280-2.
We experienced 4 patients with total occlusion of the subclavian vein in whom permanent pacemakers were implanted. Occlusion of the subclavian vein was not clinically apparent in these 4 patients. The pacing lead was inserted through the contralateral subclavian vein in a 65-year-old male. In a 80-year-old male, the pacing lead was inserted trough the internal jugular vein because of occlusion of both subclavian veins. The pacing lead was passed through the occluded portion of the innominate vein in a 84-year-old male. Phlebography-guided venipuncture was not difficult in a 79-year-old female whose mid-portion of the subclavian vein was occluded. All patients have done well since permanent pacemaker implantation. Preoperative phlebography should be performed as it may provide useful information concerning pathological alterations in the venous system that might hinder smooth implantation of the pacemaker. A review of the literature revealed no reports concerning methods in which pacing leads are passed through totally occluded portions of the subclavian vein. We here report 4 patients with total occlusion of the subclavian vein in whom permanent pacemakers were implanted via different venous routes.
我们遇到了4例锁骨下静脉完全闭塞且植入了永久性起搏器的患者。这4例患者的锁骨下静脉闭塞在临床上并不明显。在一名65岁男性患者中，起搏导线经对侧锁骨下静脉插入。在一名80岁男性患者中，由于双侧锁骨下静脉闭塞，起搏导线经颈内静脉插入。在一名84岁男性患者中，起搏导线穿过无名静脉的闭塞部分。在一名锁骨下静脉中段闭塞的79岁女性患者中，静脉造影引导下的静脉穿刺并不困难。自永久性起搏器植入以来，所有患者情况良好。术前应进行静脉造影，因为它可能提供有关静脉系统病理改变的有用信息，这些改变可能会阻碍起搏器的顺利植入。文献回顾显示，没有关于起搏导线穿过锁骨下静脉完全闭塞部分的方法的报道。我们在此报告4例锁骨下静脉完全闭塞且通过不同静脉途径植入永久性起搏器的患者。
