Cephalic vein access by modified Seldinger technique for lead implantations

Area of Science:

• Cardiology
• Medical Devices
• Vascular Access

Background:

• Traditional methods for cardiac implantable electronic device (CIED) venous access include cephalic vein cut down or axillary/subclavian vein puncture.
• Axillary/subclavian approaches risk serious complications like pneumothorax and lead damage.
• Cephalic vein cut down, while safer, often presents technical challenges and lower success rates.

Purpose of the Study:

• To evaluate a novel, simplified modified Seldinger technique for cephalic venous access in CIED implantation.
• To assess the efficacy and success rates of this technique across different CIED systems (single, dual, and triple lead).

Main Methods:

• A prospective study of 221 patients undergoing de novo CIED implantation over one year.
• Utilized a modified Seldinger technique for cephalic vein catheterization.
• Assessed the success rate of lead placement exclusively via the cephalic vein.

Main Results:

• A suitable cephalic vein was identified in 83% of patients.
• Successful lead placement exclusively via the cephalic vein was achieved in 98% of single-chamber and 99% of dual-chamber CIED implantations.
• Complete three-lead placement via cephalic access was successful in 72% of cardiac resynchronization therapy implants.

Conclusions:

• A technically simple, modified Seldinger technique for cephalic venous catheterization is highly effective for CIED lead implantation.
• This approach offers high success rates for all types of CIED lead placements.
• The technique provides a safe and efficient alternative for venous access in CIED procedures.