Spontaneous subclavian venous occlusion before electronic device implantation

Abstract

Background: Subclavian venous occlusion sometimes precludes the ability to insert leads during placement of a cardiac implantable electronic device. This study was performed to identify the risk factors for spontaneous subclavian venous occlusion prior to placement of an implantable electronic device.

Methods: We studied 446 patients who underwent axillary-subclavian venography to assess for occlusion and/or anomaly of the subclavian vein or associated veins before electronic device implantation.

Results: Six (1.3%) patients had venous occlusion (left subclavian vein in 5, left innominate vein in 1). There was a significantly higher incidence of previous cancer in the occlusion group than in the nonocclusion group (11.5% vs. 50%, p = 0.03).

Conclusions: Subclavian venous occlusion may be present before cardiac implantable electronic device placement. A history of cancer represents a risk factor subclavian venous occlusion, and patients with this risk factor should undergo subclavian venography prior to electronic device placement.

Keywords: Defibrillators; Neoplasms; Pacemaker; Subclavian vein; Venous thrombosis; artificial; implantable.