Spontaneous subclavian venous occlusion before electronic 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.