PDF(Pubmed)
Abstract：
UNASSIGNED: Insertion of electrode catheters into the coronary sinus (CS) through the right internal jugular vein (RIJV) carries risks of pneumothorax and severe hematoma formation. This study was performed to compare the safety and feasibility of catheterization through the left cubital superficial vein versus the RIJV.
UNASSIGNED: This prospective nonrandomized study involved consecutive patients who underwent catheter ablation from September 2021 to February 2023. Blind puncture techniques were used in the left cubital vein group; ultrasound-guided insertion was performed in the RIJV group. The success rates of sheath insertion and CS catheterization, the procedure and fluoroscopy times of CS cannulation, and complications were compared between groups.
UNASSIGNED: The left cubital vein group comprised 152 patients, and the RIJV group comprised 58 patients. The sheath insertion success rate was significantly lower in the cubital vein group than in the RIJV group (84.9% vs 100%, respectively; p = .0008). In the cubital vein group, blind puncture attempts failed in 20 patients; three patients developed guidewire-induced venous injury. One arterial puncture occurred in the RIJV group. After successful sheath insertion, no significant differences were observed in the CS cannulation success rate (97% vs 100%, p = .55), procedure time (median [range], 93 [51-174] vs 74 [44-129] s; p = .19), or fluoroscopy time (median [range], 66 [36-134] vs 48 [30-92] s; p = .17). No serious complications requiring procedural discontinuation occurred.
UNASSIGNED: The left cubital vein approach is practical, offering a viable alternative to the RIJV approach.
UNASSIGNED: This prospective nonrandomized study involved consecutive patients who underwent catheter ablation from September 2021 to February 2023. Blind puncture techniques were used in the left cubital vein group; ultrasound-guided insertion was performed in the RIJV group. The success rates of sheath insertion and CS catheterization, the procedure and fluoroscopy times of CS cannulation, and complications were compared between groups.
UNASSIGNED: The left cubital vein group comprised 152 patients, and the RIJV group comprised 58 patients. The sheath insertion success rate was significantly lower in the cubital vein group than in the RIJV group (84.9% vs 100%, respectively; p = .0008). In the cubital vein group, blind puncture attempts failed in 20 patients; three patients developed guidewire-induced venous injury. One arterial puncture occurred in the RIJV group. After successful sheath insertion, no significant differences were observed in the CS cannulation success rate (97% vs 100%, p = .55), procedure time (median [range], 93 [51-174] vs 74 [44-129] s; p = .19), or fluoroscopy time (median [range], 66 [36-134] vs 48 [30-92] s; p = .17). No serious complications requiring procedural discontinuation occurred.
UNASSIGNED: The left cubital vein approach is practical, offering a viable alternative to the RIJV approach.
摘要：
■通过右颈内静脉（RIJV）将电极导管插入冠状窦（CS）会导致气胸和严重血肿形成。进行这项研究是为了比较通过左肘浅静脉与RIJV进行导管插入的安全性和可行性。
这项前瞻性非随机研究涉及2021年9月至2023年2月连续接受导管消融的患者。左肘静脉组采用盲穿刺技术；RIJV组采用超声引导下插入。鞘管插入和CS导管插入的成功率，CS插管的程序和透视次数，比较两组并发症发生情况。
■左肘静脉组包括152名患者，RIJV组包括58例患者。肘静脉组的鞘插入成功率明显低于RIJV组（84.9％vs100％，分别为；p=.0008）。在肘静脉组，20例患者的盲穿刺尝试失败;3例患者发生导丝引起的静脉损伤.RIJV组发生1次动脉穿刺。成功插入护套后，CS插管成功率无显著差异(97%vs100%,p=.55)，手术时间(中位数[范围]，93[51-174]vs74[44-129]s;p=.19)，或透视时间(中位数[范围]，66[36-134]vs48[30-92]s；p=.17)。没有发生需要停止手术的严重并发症。
■左肘静脉入路是实用的，为RIJV方法提供可行的替代方案。
这项前瞻性非随机研究涉及2021年9月至2023年2月连续接受导管消融的患者。左肘静脉组采用盲穿刺技术；RIJV组采用超声引导下插入。鞘管插入和CS导管插入的成功率，CS插管的程序和透视次数，比较两组并发症发生情况。
■左肘静脉组包括152名患者，RIJV组包括58例患者。肘静脉组的鞘插入成功率明显低于RIJV组（84.9％vs100％，分别为；p=.0008）。在肘静脉组，20例患者的盲穿刺尝试失败;3例患者发生导丝引起的静脉损伤.RIJV组发生1次动脉穿刺。成功插入护套后，CS插管成功率无显著差异(97%vs100%,p=.55)，手术时间(中位数[范围]，93[51-174]vs74[44-129]s;p=.19)，或透视时间(中位数[范围]，66[36-134]vs48[30-92]s；p=.17)。没有发生需要停止手术的严重并发症。
■左肘静脉入路是实用的，为RIJV方法提供可行的替代方案。
