Key result
Ultrasound-guided axillary vein puncture has emerged as a highly successful and safe alternative to standard approaches for CIED implantation, offering a short learning curve and low complication rates.
Why the study?
CIED implantation carries surgical risks including accidental puncture of intrathoracic structures, prompting the evaluation of safer alternative venous access strategies such as ultrasound-guided axillary vein puncture.
Does ultrasound-guided axillary vein puncture improve procedural success and reduce complications compared to alternative venous access techniques in patients undergoing CIED implantation?
Does ultrasound-guided axillary vein puncture improve procedural success and reduce complications compared to alternative venous access techniques in patients undergoing CIED implantation?
Ultrasound-guided axillary vein puncture is a highly successful, safe, and efficient alternative to standard venous access techniques for CIED implantation, supporting its potential adoption as a new standard of care.
Answers are grounded in this paper and cite their sources.
May warrant consideration for CIED venous access; leaves open confirmation of superiority in randomized trials.
Cardiac stimulation therapy has evolved significantly over the past 30 years. Currently, cardiac implantable electronic devices (CIED) are the mainstream therapy for many potentially lethal heart conditions, such as advanced atrioventricular block or sustained ventricular tachycardia or fibrillation. Despite sometimes being lifesaving, the implant is surgical and therefore carries all the inevitable intrinsic risks. In the process of technology evolution, one of the most important factors is to make it safer for the patient. In the context of CIED implants, complications include accidental puncture of intrathoracic structures. Alternative strategies to intrathoracic subclavian vein puncture include cephalic vein dissection or axillary vein puncture, which can be guided by fluoroscopy, venography or, more recently, ultrasound. In this article, the authors analyse the state of the art of ultrasound-guided axillary vein puncture using evidence from landmark studies in this field.
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Tagliari et al. (2020) conducted a review in Cardiac implantable electronic device (CIED) implantation. Ultrasound-guided axillary vein puncture vs. Standard access techniques (cephalic vein dissection, subclavian vein puncture) was evaluated. Ultrasound-guided axillary vein puncture has emerged as a highly successful and safe alternative to standard approaches for CIED implantation, offering a short learning curve and low complication rates.
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