Novel extrathoracic puncture techniques for pacemaker lead insertion: Pitfalls of the conventional extrathoracic puncture method
Novel extrathoracic puncture techniques for pacemaker lead insertion: Pitfalls of the conventional extrathoracic puncture method
复制标题
用于起搏器引线插入的新型胸腔外穿刺技术：传统胸腔外穿刺方法的缺陷
DOI：
10.1016/j.joa.2012.03.008
复制
发表时间：
2012
影响因子：
2
通讯作者：
M. Muto
中科院分区：
文献类型：
--
作者：
Kohei Sawasaki;Terumori Sato;Yohei Takayama;Shigeki Yokota;Y. Morita;Masakazu Kobayashi;Makoto Saito;C. Takanaka;M. Muto
起搏器植入的手术程序因机构而异。胸外静脉穿刺方法已被用于电极导线插入，尽管患者的身体运动可能会使目标静脉从造影剂注射区域移位以进行成像。穿刺失败会导致穿刺部位周围水肿、痉挛或出血导致的静脉塌陷，这可能会导致无法进行另一次穿刺。为了克服这些问题，我们报告了一种新的技术，为胸外穿刺method.Methods和resultsFrom 2007年4月至2011年3月，我们进行了35个新的双腔起搏器植入手术。本研究比较了传统穿刺组（2007年4月至2009年3月; A组）与导管引导穿刺组（2009年4月至2011年3月; B组）。我们分析了每组的手术时间和手术相关并发症。常规穿刺组（A组）的手术时间为138.6±41.8 min，导管引导穿刺组（B组）的手术时间为109.8±23.2 min。与传统穿刺组（A组;p=0.016）相比，导管引导穿刺组（B组）的手术时间显著缩短。两组患者均无气胸、血肿或任何其他并发症。ConclusionOur puncture method involving catheter insertion似乎是安全有效的。
IntroductionSurgical procedures for pacemaker implantation vary among facilities. The extrathoracic venous puncture method has been utilized for lead insertion, although patients' body movements can displace the targeted vein from the area into which a contrast agent has been injected for imaging. Failed punctures cause edema around the puncture site, spasm, or venous collapse due to bleeding, which may render another puncture impractical. To overcome these problems, we report a new technique for the extrathoracic puncture method.Methods and resultsFrom April 2007 through March 2011, we performed 35 new dual chamber pacemaker implantation procedures. This study compared a conventional puncture group (from April 2007 through March 2009; Group A) with a catheter‐guided puncture group (from April 2009 through March 2011; Group B). We analyzed procedure time and procedure‐related complications in each group. The procedure time was 138.6±41.8 min in the conventional puncture group (Group A) and 109.8±23.2 in the catheter‐guided puncture group (Group B). There was a significant reduction in the procedure time in the catheter‐guided puncture group (Group B) compared with the conventional puncture group (Group A;p=0.016). No patients in either group had pneumothorax, hematoma, or any other complications.ConclusionOur puncture method involving catheter insertion appears to be safe and effective.