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Updated: Apr 18, 2026
Computed Tomography (CT) Guided Implantation of a Totally Implantable Venous Access Port (TIVAP) through Subclavian Vein
Published on: January 13, 2026
Spontaneous subclavian venous occlusion before electronic device implantation
Takeshi Kodani1, Takanao Mine2, Hideyuki Kishima1
1Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, Nishinomiya, Japan.
Insights
A history of cancer is a significant risk factor for subclavian venous occlusion, which can complicate cardiac implantable electronic device placement. Patients with prior cancer should undergo subclavian venography before device implantation.
Area of Science:
- Cardiology
- Vascular Medicine
- Medical Device Implantation
Background:
- Subclavian venous occlusion can impede lead placement for cardiac implantable electronic devices (CIEDs).
- Identifying pre-procedural risk factors for venous occlusion is crucial for successful CIED implantation.
Purpose of the Study:
- To identify risk factors for spontaneous subclavian venous occlusion before CIED placement.
- To evaluate the association between patient history and venous anomalies.
Main Methods:
- Axillary-subclavian venography was performed on 446 patients prior to CIED implantation.
- Venous occlusion and anomalies of the subclavian and associated veins were assessed.
Main Results:
- Six patients (1.3%) exhibited venous occlusion (5 left subclavian, 1 left innominate).
- A history of cancer was significantly more prevalent in patients with venous occlusion (50%) compared to those without (11.5%, p=0.03).
Conclusions:
- Subclavian venous occlusion can be present before CIED procedures.
- A history of cancer is a notable risk factor for subclavian venous occlusion.
- Pre-procedural subclavian venography is recommended for patients with a history of cancer before CIED placement.
Background:
Subclavian venous occlusion sometimes precludes the ability to insert leads during placement of a cardiac implantable electronic device. This study was performed to identify the risk factors for spontaneous subclavian venous occlusion prior to placement of an implantable electronic device.
Methods:
We studied 446 patients who underwent axillary-subclavian venography to assess for occlusion and/or anomaly of the subclavian vein or associated veins before electronic device implantation.
Results:
Six (1.3%) patients had venous occlusion (left subclavian vein in 5, left innominate vein in 1). There was a significantly higher incidence of previous cancer in the occlusion group than in the nonocclusion group (11.5% vs. 50%, p = 0.03).
Conclusions:
Subclavian venous occlusion may be present before cardiac implantable electronic device placement. A history of cancer represents a risk factor subclavian venous occlusion, and patients with this risk factor should undergo subclavian venography prior to electronic device placement.
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