Axillary Venipuncture Research Of Permanent Cardiac Pacemaker Implanted Electrodes

Research background:For a long time,mainly through the subclavian vein or cephalic vein into the permanent cardiac pacemaker electrode,but the subclavian vein circuit and wire fracture,"subclavian compression syndrome",pneumothorax,hemopneumothorax and other serious complications are closely related.Implanted electrodes by using venous access or use recently described but is still not widely accepted axillary vein circuit,can avoid the complications.According to the practice in recent years and summary the clinical use of axillary vein implanted pacemaker electrode,axillary vein circuit is also a kind of ideal vein into the road.By the axillary vein implanted pacemaker electrode method is more,for each method has its own advantages and disadvantages and operation skills,clinical choose to carefully select the most appropriate method according to actual situation.Objective:Explore the vein angiography puncture axillary vein implanted pacemaker electrode the feasibility,safety and effectiveness,and contrast the axillary vein recently and distal acupuncture efficacy and safety of the implanted electrodes.Methods: Choose need permanent cardiac pacemaker implantation patients 150 cases,randomly divided into 3 groups,axillary vein proximal(The axillary vein paragraph 3),distal axillary vein group(The axillary vein paragraph 1and2),subclavian vein group,all operations are performed by the same performer.Axillary vein group patients were in the back of indwelling trocar,piercing before axillary vein angiography.Implanted pacemaker electrode comparing three groups puncture of the one-time success rate of puncture,total success rate,total cost time and local complications(pneumothorax,hemothorax,puncture of the arteries,puncture of nerve),etc.Results: 1.Axillary vein proximal,distal axillary vein group,the group of subclavian vein puncture total success rate are 94%,88% and 94% respectively,three groups of patients there was no statistical significance(P > 0.05).2.Axillary vein proximal,distal axillary vein group,the group of subclavian vein puncture time were 108.10±35.76(s),110.70±38.14(s),99.89±31.01(s),no difference were observed in the three groups of patients were compared with statistical significance(P > 0.05).3.Axillary vein proximal,distal axillary vein group,group of subclavian vein puncture times puncture were 2.1 ±1.39(times),2.26±1.64(times),1.35±0.86(time),axillary vein proximal and distal group,there was no statistically significant difference compared with axillary vein proximal and distal group,respectively,compared with the subclavian vein group differences were statistically significant(P < 0.05).4.Axillary vein proximal,distal axillary vein group,patients with subclavian vein group a success rate of 60.0%,56.0% and 80.0%,respectively,compared with axillary vein proximal and distal group there was no statistically significant difference,axillary vein proximal and distal group,respectively,compared with the subclavian vein group differences were statistically significant(P < 0.05)5.There was no statistically significant difference comparing the three groups of patients with complications,may be associated with less sample size,but the subclavian vein group is 2 cases of pneumothorax,wear into the artery in 2 cases,1 case appeared pouch hematoma,axillary vein proximal group is 1 case pneumothorax,1 case of puncture of artery,axillary vein occurred in 1 case distal group pouch hematoma pneumothorax rate is 0.Conclusion: 1.Via peripheral vein angiography puncture axillary vein implanted with permanent pacemaker electrode strong practicability.2.Via the axillary vein implanted with permanent pacemaker electrode method of the subclavian vein has a lower incidence of complications.3.Proximal and distal axillary vein puncture time,success rate of puncture,there was no statistically significant difference comparison,but the remote pneumothorax complications of 0.