Modified Pull-Through Technique for Cardiac Resynchronization Therapy Upgrades in Patients with Occluded Access Veins

Area of Science:

• Cardiology
• Medical Devices
• Interventional Cardiology

Background:

• Implantable cardiac resynchronization therapy (CRT) device upgrades are increasingly common.
• Venous access occlusion presents a significant challenge during these procedures.
• Existing collateral networks can be leveraged for intervention.

Purpose of the Study:

• To present a modified pull-through technique for recanalizing occluded access veins during CRT device upgrades.
• To evaluate the feasibility and safety of this modified technique.

Main Methods:

• A modified pull-through method was employed.
• Transfemoral access was used to snare the existing atrial lead.
• Recanalization of the occluded access vein was performed.
• Six consecutive patients with occluded veins and collateral networks were included.

Main Results:

• The modified pull-through technique was successful in all six patients.
• Device upgrades were completed successfully in all cases.
• No intraprocedural complications were observed.

Conclusions:

• The modified pull-through technique is a feasible and safe alternative for CRT device upgrades in patients with venous occlusion.
• This method offers a viable solution to a common procedural challenge.