How‐to Manual for Pacemaker and ICD Devices Procedures and Programming Ebook PDF
How‐to Manual for Pacemaker and ICD Devices Procedures and Programming Ebook PDF The cephalic vein has been used for access and parallel to the deltopectoral groove, or perpendicular. lead placement ever since transvenous leads were developed. The cephalic vein offers relatively easy access into the central venous system with a very low risk of complications . There is essentially no risk of pneumothorax with the cephalic vein cut‐down compared with axillary or subclavian puncture. In addition, lead longevity with cephalic access is superior to that of other common techniques such as access via axillary or subclavian veins . This is because of a more gentle angle of entry with cephalic access and a lower risk of subclavian crush to the lead when compared with subclavian access [3,4].
Some physicians use cephalic access for all device implants, while others use it only for selected patients. All physicians should become proficient with implants via cephalic access as it can be useful in patients with access challenges, such as those who have a high risk of complications such as pneumothorax, as well as patients where the longevity of the lead is of prime importance such as young patients.
In this chapter we describe the techniques to gain access into the cephalic vein as well as some of the potential challenges and pitfalls.
Procedure Description An important aspect of the cephalic vein cut‐down procedure is an understanding of the anatomy of the pectoralis and deltoid muscle areas as they relate to the location of the vein. The cephalic vein runs in the deltopectoral groove. On the skin, this is the groove where the shoulder meets the chest and is visible and palpable in most people The incision can be made either .