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Success and complication rate of fluoroscopic, doppler, and contrast venography-guided subclavian venous puncture for implantation of cardiovascular electronic devices

1 Department of Interventional Cardiology, Paras Hospital Gurugram, Haryana, India
2 Department of Cardiology, MMIMSR, Ambala, Haryana, India
3 Department of Endocrinology, All is Well Multi-Speciality Hospital, Burhanpur, Madhya Pradesh, India
4 Department of Cardiology, BHMRC, Delhi, New Delhi, India

Correspondence Address:
Tauseef Nabi,
All is Well Multi-Speciality Hospital, Burhanpur, Madhya Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmedsci.jmedsci_1_21

Background: Cardiovascular implantable electronic devices (CIED) are life-saving devices, but may lead to puncture-related complications during implantation. Aim: The aim of this study was to compare the success and complications of the subclavian venous puncture under the guidance of fluoroscopy, venography, and Doppler. Methods: This was a prospective observational study conducted for one year at a tertiary health center in North India. We studied the clinical profile, success, and complications in three puncture techniques for CIED lead implantation in 75 adult patients of >18 years of age, randomized in three equal groups of 25 participants. Results: The mean age was 66.6 ± 15.6 years, with the majority being males. The left-sided approach for lead implantation was common (84%). Pacemakers were most commonly implanted CIED devices. The overall success of punctures was 100% each in Doppler and venography group, and 92% in the fluoroscopic-guided venous puncture group. Success in the first attempt was observed in 48% in the Doppler group and 24% each in the fluoroscopic and venographic group. There were total of 12 complications, the most common were arterial puncture (10.7%), followed by major hematoma (4%), and pneumothorax (1.3%). The fluoroscopic group had maximum complications (83%), followed by the venography group. Significantly higher arterial punctures occurred in the fluoroscopic venous puncture group. Conclusion: There were 100% success in the Doppler and venographic groups and only 92% success in the fluoroscopic venous puncture group. Maximum complications were seen in the fluoroscopic group, with significantly higher arterial punctures seen in the fluoroscopic venous puncture group.


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    -  Kumar A
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