ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2026
Venoplasty-facilitated cardiac implantable electronic device implantation and upgrade: feasibility and outcomes from a single center.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundVenous occlusion represents a significant challenge during de novo implantation or upgrading of cardiac implantable electronic devices (CIEDs), particularly in patients with chronic transvenous leads. Venoplasty may restore venous access while avoiding contralateral implantation or transvenous lead extraction (TLE).
objectiveTo evaluate the feasibility, safety, and procedural outcomes of venoplasty in patients with venous obstruction undergoing de novo CIED implantation or device upgrade.
methodsIn this single-center retrospective study, 12 patients (median age 69 years; 75% male) who underwent venoplasty for total or subtotal venous occlusion identified by venography between December 2022 and December 2024 were included. Two patients underwent de novo CIED implantation and ten underwent device upgrade procedures. Venoplasty was performed using antegrade or retrograde approaches under fluoroscopic guidance, followed by standard CIED implantation.
resultsTotal venous occlusion was present in six patients and subtotal occlusion in six. The most common sites of obstruction were the brachiocephalic and subclavian veins. Antegrade venoplasty was successful in 11 patients, while retrograde femoral access was required in one case. Successful venous recanalization and CIED implantation were achieved in all patients (procedural success rate: 100%) without procedural complications. One patient developed subacute thrombosis related to anticoagulant non-compliance during follow-up.
conclusionVenoplasty is a feasible, effective, and safe strategy for managing venous occlusion during de novo CIED implantation or device upgrade, reducing the need for contralateral access or TLE. This approach should be considered in appropriately selected patients at experienced centers.
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