Site of left axillary vein crossing the clavicle: an analysis with computed tomography venography as a guide for vein puncture for device implantation

作者全名："Gao, Jie; Zhou, Yang; Lei, Sen; Qin, ChunChang"

作者地址："[Gao, Jie; Lei, Sen; Qin, ChunChang] Chongqing Med Univ, Affiliated Hosp 1, Dept Cardiol, Chongqing, Peoples R China; [Zhou, Yang] Chongqing Med Univ, Affiliated Hosp 1, Dept Radiol, Chongqing, Peoples R China"

通信作者："Lei, S; Qin, CC (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Cardiol, Chongqing, Peoples R China."

来源：JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000926352200002

JCR分区：Q3

影响因子：2.1

年份：2023

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Axillary vein; Vascular access; Influencing factors; Blind axillary vein puncture

摘要："BackgroundBlind axillary venous access is a convenient but technically difficult approach for cardiac rhythm device lead implantation. We try to explore whether there are rules on the axillary vein course to facilitate blind venous cannulation.MethodsIn a single-center, retrospective study, we included 155 patients who underwent computed tomography venography (CTV) examination of left axillary vein. All scans were reviewed for the relationship between left axillary vein and clavicle, vein steepness, and depth. Factors probably affecting above indicators were analyzed.ResultsThe location of left axillary vein crossing the clavicle was mainly concentrated around the medial 1/3 of clavicle, with mean crossing location of the medial 1/3 of clavicle, which was not correlated with sex, age, abdominal subcutaneous fat thickness, upper thoracic kyphosis angle, or the angle between clavicle and anterior midline (P < 0.05). The average angle between axillary vein and horizontal line was 31.57 +/- 11.72 degrees, which was positively associated with age, whereas inversely associated with the angle between clavicle and anterior midline (P < 0.05). The proximal axillary vein ran more and more shallow until becoming the subclavian vein (P < 0.01); and it had a mean depth of 3 cm, which was significantly associated with abdominal subcutaneous fat thickness (P < 0.05).ConclusionsThe left axillary vein and clavicle had a relatively fixed relationship that axillary vein commonly crossed the medial 1/3 of clavicle. The average angle between axillary vein and horizontal line was 31.57 +/- 11.72 degrees, associated with age and the clavicle course. The mean depth of proximal axillary vein was 3 cm, and patients with larger weight had a deeper position of axillary vein."

基金机构：National Natural Science Foundation of China [82070523]; Chongqing Science and Technology Bureau [cstc2019jscxmsxmX0307]; Chongqing Health Commission [2020msxm113]

基金资助正文："This work was supported by the National Natural Science Foundation of China (No. 82070523), Chongqing Science and Technology Bureau (No. cstc2019jscxmsxmX0307), and Chongqing Health Commission (No. 2020msxm113)."