METHODS: Our retrospective study included patients who had RHC from the arm between November 1, 2019, and December 31, 2022 that was unsuccessful due to the inability to pass a catheter through the SVS, and then underwent balloon venoplasty. The success rate of completed RHC was then assessed.
RESULTS: Out of 2506 RHCs via arm access, 2488 were successful with a catheter alone or over a guidewire. In 18 patients, venoplasty was needed for catheter passage over a guidewire. Post-dilatation, all 18 cases (100%) had successful RHC with a mean procedural time of 35.2 (SD = 15.5) minutes. The most common stenosis site was the subclavian vein in 13 patients (72.2%), and 12 patients (66.7%) had pacemaker/ implantable cardioverter defibrillator wires present.
CONCLUSIONS: Balloon dilatation of SVS is an efficacious method to improve the success rate of RHC from the arm. It is a safe technique that may prevent cross-over to a different access site, thereby improving patient satisfaction and reducing the possibility of alternate site complications.
方法:我们的回顾性研究包括在2019年11月1日至2022年12月31日之间从手臂接受RHC的患者,由于无法通过导管穿过SVS,然后做了气囊静脉成形术.然后评估完成的RHC的成功率。
结果:在2506个通过手臂进入的RHC中,2488只使用导管或在导丝上成功。在18名患者中,导管通过导丝需要进行静脉成形术.后扩张,所有18例(100%)均成功进行RHC,平均手术时间为35.2分钟(SD=15.5分钟).13例(72.2%)患者中最常见的狭窄部位是锁骨下静脉,12例患者(66.7%)存在起搏器/植入式心律转复除颤器导线。
结论:球囊扩张SVS是提高手臂RHC成功率的有效方法。这是一种安全的技术,可以防止交叉到不同的访问站点,从而提高患者满意度并减少替代部位并发症的可能性。