BACKGROUND A wireless pulmonary artery pressure sensor (CardioMEMS) is approved for implantation via the femoral vein. The internal jugular vein (IJ) is an attractive alternative access route commonly used in pulmonary artery catheterization. METHODS AND RESULTS Retrospective chart review was performed for all sensor implants from 10 providers at 4 centers from September 2016 to June 2018. To compare procedural outcomes and discharge efficiency between groups, multivariate analyses incorporating potential confounders were performed. Seventy-three (28%) patients had femoral access, and 189 (72%) had IJ access; demographics were similar between the groups. Complications, including one case of hematoma and 4 cases of mild hemoptysis, and 30-day mortality (2%-3%) did not differ between groups. Provider preference for IJ access substantially increased over time, with IJ accounting for 90% of cases in 2018. After risk-adjustment, IJ cases had 20% (5%-33%) shorter fluoroscopy time (P=0.01) and 24% (7%-38%) lower contrast volume (P=0.008). Compared with outpatient femoral cases, outpatient IJ cases had 62% (52%-69%) faster needle-to-door time and were 34 times (6-235) more likely to have same-day discharge (P<0.001 for both). CONCLUSIONS IJ access for CardioMEMS implant is a safe alternative associated with superior procedural and discharge outcomes. Implanters at 4 high-volume centers adopted IJ access as the preferred implant approach.

中文翻译：

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颈内静脉作为无线肺动脉压力传感器植入的替代通路。

背景技术无线肺动脉压力传感器（CardioMEMS）被批准用于经由股静脉植入。颈内静脉（IJ）是肺动脉导管插入术中常用的一种有吸引力的替代性通路。方法和结果自2016年9月至2018年6月，对来自4个中心的10家医疗服务提供者的所有传感器植入物进行了回顾性图表审查。为了比较各组之间的手术结果和出院效率，进行了包含潜在混杂因素的多因素分析。73例患者（28％）有股骨入路，189例患者（72％）有IJ入路；两组之间的人口统计学相似。两组之间的并发症（包括1例血肿和4例轻度咯血）和30天死亡率（2％-3％）没有差异。随着时间的流逝，提供者对IJ接入的偏好大大增加，2018年IJ占病例的90％。经过风险调整后，IJ病例的透视时间缩短了20％（5％-33％）（P = 0.01）和24％（降低了7％（-38％）（P = 0.008）。与门诊股骨病例相比，门诊IJ病例的上门针刺时间缩短了62％（52％-69％），并且当天出院的可能性增加了34倍（6-235）（P <0.001） 。结论CardiMEMS植入物的IJ通路是一种安全的替代方法，具有优越的手术和出院效果。4个高产量中心的植入器采用IJ通道作为首选的植入方法。与门诊股骨病例相比，门诊IJ病例的上门针刺时间缩短了62％（52％-69％），并且当天出院的可能性增加了34倍（6-235）（两者均P <0.001） 。结论CardiMEMS植入物的IJ通路是一种安全的替代方法，具有优越的手术和出院效果。4个高产量中心的植入器采用IJ通道作为首选的植入方法。与门诊股骨病例相比，门诊IJ病例的上门针刺时间缩短了62％（52％-69％），并且当天出院的可能性增加了34倍（6-235）（两者均P <0.001） 。结论CardiMEMS植入物的IJ通路是一种安全的替代方法，具有优越的手术和出院效果。4个高产量中心的植入器采用IJ通道作为首选的植入方法。