  |
|
 |
|
Case Report
| ||||||
| Supraclavicular course of the cephalic vein | ||||||
| Juan David Ramírez1, Luis Carlos Sáenz2, Diego Rodríguez3, Alejandro Jiménez Restrepo3, Francisco Villegas3 | ||||||
|
1MD, Fellow of electrophysiology, Electrophysiology Service, International Arrhythmia Center "Andrea Natale", Fundación Cardioinfantil, Universidad de la Sabana, Bogotá, Colombia.
2MD, Chief of Electrophysiology Service, International Arrhythmia Center "Andrea Natale", Fundación Cardioinfantil, Universidad de la Sabana, Bogotá, Colombia. 3MD, Electrophysiology Service, International Arrhythmia Center "Andrea Natale", Fundación Cardioinfantil, Universidad de la Sabana, Bogotá, Colombia. | ||||||
| ||||||
|
[HTML Full Text]
[PDF Full Text]
[Print This Article]
[Similar article in Pumed] [Similar article in Google Scholar] 
|
| How to cite this article |
| Ramírez JD, Sáenz LC, Rodríguez D, Restrepo AJ, Villegas F. Supraclavicular course of the cephalic vein. International Journal of Case Reports and Images 2014;5(4):281–284. |
|
Abstract
|
|
Introduction:
Vascular access for transvenous pacemaker and cardioverter defibrillator implants is frequently obtained by using the cephalic cutdown technique. Sometimes anatomical variations may limit insertion of one or several leads. We describe a case of a patient with an anomalous supraclavicular course of the left cephalic vein.
Case Report: A 61-year-old male with background of ischemic heart disease, hypertension, diabetes mellitus, obstructive sleep apnea and dyslipidemia, was referred to our institution after four months of recurrent syncopal episodes. A bradycardia-tachycardia syndrome was diagnosed and decided to proceed with permanent pacemaker implantation. Through a cutaneous incision in the left deltopectoral groove, we dissected the tissue planes until the left cephalic vein became visible. Fluoroscopy in anterior-posterior projection showed clear supraclavicular course of the cephalic vein. This access was abandoned by removing both wires and ligating the proximal end of the cephalic vein. Through a fluoroscopy/venogram guided axillary puncture using the modified Seldinger technique and the retained wire technique, double central vein access was secured, allowing the passage of right atrial and ventricular leads. A dual chamber pacemaker was implanted. Conclusion: Although the supraclavicular course of the cephalic vein is a rare anatomical variant, it is important to recognize its presence as it may lead to potential complications related to lead dysfunction, erosion or collateral vascular damage if used as an access for permanent lead placement. Alternative central vein access is strongly recommended in such cases. | |
|
Keywords:
Pacemaker, Implantable cardioverter-defibrillator, Cephalic vein, Implanted electrode
| |
|
[HTML Full Text]
[PDF Full Text]
|
|
Author Contributions
Juan David Ramírez – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Luis Carlos Sáenz – Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published Diego Rodríguez – Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published Alejandro Jiménez Restrepo – Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published Francisco Villegas – Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published |
|
Guarantor of submission
The corresponding author is the guarantor of submission. |
|
Source of support
None |
|
Conflict of interest
Authors declare no conflict of interest. |
|
Copyright
© Juan David Ramírez et al. 2014; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
|
|