Boston Scientific EASYTRAK 2 IS-1, Руководство врача-руководителя

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EASYTRAK 2 IS-1 LEAD—IMPLANTATION
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5. Feel with the thumb the pressure from the passage of the needle
through the superficial fascia; direct the needle deep into the tissues
toward the subclavian vein and the underlying first rib. Fluoroscopic
guidance will reduce the chance that the needle would pass below the
first rib and into the lung.
CAUTION: When implanting the lead via a subclavian puncture, allow slack
in the lead between the suture sleeve and the venous entry site. This will
help minimize flexing at the suture sleeve and interaction with the
clavicle/first rib region.
Positioning the Lead
Positioning the lead includes the following steps:
1. Insert a guiding catheter into the ostium of the coronary sinus to
provide a path for lead placement.
2. Obtain a venogram to visualize the coronary venous system.
3. Place the lead through the guiding catheter in the coronary venous
system by advancing the lead over a guide wire.
Referring to Figure 4, the lead is introduced into the coronary venous
system through the ostium of the coronary sinus and advanced into its
tributaries. The coronary sinus and its tributaries include the great cardiac
vein, middle cardiac vein, left posterior vein, and left marginal vein. All
cardiac veins are potential sites for implantation of the EASYTRAK™ 2 IS-1
lead. Variability in patient anatomy may preclude placement in one or more
of the suggested sites.
Figure 3. Location of thumb and needle entry.
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356995-051 EN Europe.book Page 12 Monday, August 8, 2011 3:43 PM