New Technique for Preserving Cephalic Vein Flow in Pacemaker Implantation Ipsilateral to Arteriovenous Fistula.

although there is not enough evidence to recommend device implantation contralateral to an arteriovenous fistula. 3 Small observational studies have demonstrated that arteriovenous fistula construction in patients with CIED may increase primary arteriovenous fistula failure on the same side, 8 and that there is a higher incidence of central venous stenosis in patients with ipsilateral CIED and arteriovenous fistula, comparing to patients with contralateral strategy. 9 In a retrospective cohort, 2 there were higher rates of central vein intervention in ipsilateral cases, even if the need for intervention in arteriovenous hemodialysis accesses were similar in both groups. In that study, ipsilateral cases corresponded more frequently to patients in which arteriovenous fistulas were constructed after CIED implantation (81%) and contralateral cases to patients with arteriovenous fistulas prior to CIED implantation (56%), thus suggesting that the maturity of the arteriovenous fistula may play an important role in the prevention of deep venous