Key result
Axillary vein puncture is a safe and effective alternative for venous access during cardiac device implantation, offering success rates comparable to subclavian puncture with a lower risk of complications.
Why the study?
Does axillary vein puncture improve success rates and reduce complications compared to subclavian vein puncture or cephalic vein phlebotomy in patients undergoing IECD implantation?
Does axillary vein puncture improve success rates and reduce complications compared to subclavian vein puncture or cephalic vein phlebotomy in patients undergoing IECD implantation?
Axillary vein puncture is a safe and effective alternative to subclavian and cephalic vein access for cardiac device implantation, offering comparable success rates with a lower risk of long-term electrode complications.
Answers are grounded in this paper and cite their sources.
May support axillary access to reduce complications; leaves open need for randomized trials before practice change.
Introduction: The obtaining of venous access for implantation of implantable electronic cardiac devices (IECDs) has been traditionally made by intrathoracic subclavian vein puncture (SVP) or cephalic vein phlebotomy (CVP). Evidence indicates, however, the increased risk of short-term and long-term complications with SVP due to the fact that it is intrathoracic access and the risk of compression of the electrodes by the costoclavicular ligament, leading to different types of defects. CVP, in turn, has been associated with a failure rate that reaches 45%. Axillary vein puncture (AVP) has been described in the literature and is presented here as an alternative to the two techniques mentioned. Methods: A PubMed survey was conducted on articles that mention the AVP, SVP and CVP techniques and compare them to the immediate, short and long term results and success rates for obtaining venous access. Emphasis was placed on comparisons between the various AVP techniques. Conclusion: The AVP technique for obtaining venous access presents some variations among the different authors. It has CVP-like safety, success rates comparable to those of the subclavian vein, and better medium and long term results for electrode function.
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Pegoraro et al. (2018) conducted a review in Implantable electronic cardiac device (IECD) implantation. Axillary vein puncture vs. Subclavian vein puncture or cephalic vein phlebotomy was evaluated on Success rates and complications (immediate, short, and long-term). Axillary vein puncture is a safe and effective alternative for venous access during cardiac device implantation, offering success rates comparable to subclavian puncture with a lower risk of complications.
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