Self-taught ultrasound-guided axillary vein puncture for CIED implantation achieved a 94.2% success rate with no major complications and improved after six months (p=0.002).
Does self-taught ultrasound-guided axillary vein puncture improve procedural success and safety in patients undergoing CIED implantation?
Self-taught ultrasound-guided axillary vein puncture for CIED implantation is highly successful (94.2%) and safe, with a rapid learning curve for electrophysiologists.
Absolute Event Rate: 0% vs 0%
Background: Ultrasound (US)-guided axillary vein puncture (AVP) is an established technique for cardiac implantable electronic device (CIED) implantation. Yet real-world data concerning shifting from conventional venous access into US-guided AVP are not widely available. Methods: This is a single-center prospective registry reporting safety (complications) and efficacy (success rate: i.e., accomplishment of the vein access utilizing only the initially employed approach) of self-taught US-guided AVP integration into the standard workflow of CIED procedures. Results: A total of 539 patients (mean age 71.5 ± 12.4 years old, 78.7% males) were treated in our institution over a three-year period. Regarding CIED type and lead number, 58.3% used an implantable cardioverter defibrillator, 32% used permanent pacemakers, and two leads were involved in 65.8% of the cases and three leads in 8.9%. Before integration of US-guided AVP, the venous access success rate was 93.5%. The US-guided AVP success rate was 377/400 procedures (94.2%). After the first semester of US-guided AVP utilization, a pattern of increased success rate was observed (p = 0.002) and remained stable over the following semesters. No major complication (periprocedural or 30-day mortality, hemothorax, pneumothorax and tamponade) occurred after US AVP integration in our workflow. Conclusions: The integration of US-guided AVP in a self-taught manner is feasible among electrophysiologists with experience in US-guided vascular access. A high success rate can be reached quickly and safely.
Vrachatis et al. (Fri,) reported a other. Self-taught ultrasound-guided axillary vein puncture for CIED implantation achieved a 94.2% success rate with no major complications and improved after six months (p=0.002).