Comparison of the Axillary Venous Approach and Subclavian Venous Approach for Efficacy of Permanent Pacemaker Implantation

Kim, Ki‐Hun; Park, Kyoung-Min; Nam, Gi‐Byoung; Kim, Dae-Kyeong; Oh, Minkyung; Choi, Hyung Suk; Hong, Taek Jong; Park, Bo-Min; Seo, Guang-Won; Song, Pil Sang; Kim, Dong-Kie; Seol, Sang–Hoon; Kim, Doo-IL; Kim, You‐Ho; Choi, Kee–Joon

doi:10.1253/circj.cj-13-0884

Cited by 33 publications

(19 citation statements)

References 18 publications

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“…The lower incidence of pneumothorax, ranging from 1 to 3 % for the intrathoracic subclavian approach and 0-1 % for the axillary technique [11,24,28], is explained by the extrathoracic anatomic position of the axillary vein, reducing potential serious complications especially in young patients and the time of hospitalization. Axillary vein approach seems to be preferable not only for prevention of acute complications but also to reduce lead failures rates, including loss of lead insulation and lead fracture, with a consequently better longterm PM lead survival compared with classical subclavian [13,14,28]. However, data on ICD implantation using axillary vein approach are limited.…”

Section: Discussionmentioning

confidence: 99%

Axillary vein puncture using fluoroscopic landmarks: a safe and effective approach for implantable cardioverter defibrillator leads

Migliore

Siciliano

Lazzari

et al. 2015

J Interv Card Electrophysiol

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Section: Discussionmentioning

confidence: 99%

Axillary vein puncture using fluoroscopic landmarks: a safe and effective approach for implantable cardioverter defibrillator leads

Migliore

Siciliano

Lazzari

et al. 2015

J Interv Card Electrophysiol

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“…Many techniques have been utilized for venous access during the placement of cardiac implantable electronic devices (CIEDs) . Over the past several years, practice has shifted from subclavian access to axillary vein access . While advances in sheaths, lead design, and anatomic access site have gradually improved the safety and efficacy of implantation, periprocedural risks and complications persist.…”

Section: Introductionmentioning

confidence: 99%

Predictors of successful ultrasound‐guided lead implantation

Ahmed

Gilge

Clark

et al. 2020

Pacing Clinical Electrophis

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Background Technical advances have improved the safety of cardiac implantable electronic device (CIED) insertion, but periprocedural complications persist. Despite ultrasound (US) guidance for vascular access being feasible and exhibiting shorter fluoroscopy times, it is not widely adopted for insertion of CIEDs. Thus, we studied the use of US for CIED insertion to (1) quantify the success rate of venous cannulation, (2) identify predictors of failed cannulation, and (3) quantify the rate of complications using US guidance. Methods We studied 166 consecutive patients who underwent US‐guided CIED implantation. Anatomic parameters of the axillary vein were measured. The primary outcome was success (group 1) or failure (group 2) to obtain vascular access utilizing US guidance. Secondary outcomes included pneumothorax and hematoma. Results Successful US‐guided cannulation occurred in 154 of 166 patients (93%). No patient had a pneumothorax. Hematoma occurred in 1 of 166 patients (0.01%). Group 2 exhibited higher male proportion at 11 of 12 (92%) compared with 94 of 154 (61%) in group 1 (P = .03), increased vein depth at 3.84 versus 2.85 cm (P = .003), more right‐sided implants (P = .03), higher weight at 104.6 versus 85.3 kg (P = .017), higher body mass index at 35.6 versus 29.2 kg/m2 (P = .049), and higher body surface area at 2.24 versus 1.99 m2 (P = .013). Other parameters were statistically nonsignificant. In multivariate analysis, vein depth remained significantly associated with failure. Conclusion Using US guidance for CIED implantation is successful in the vast majority (93%) of patients. Rare cases of unsuccessful cannulation were associated with right‐sided implants and increased venous depth.

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“…shown that other forms of venous access with punctures that access the vascular bed in an extrathoracic location, such as AVP, may be equal or easier, safer, and present a lower risk of short-and long-term complications [19][20][21][22][23][24] .…”

Section: Discussionmentioning

confidence: 99%

“…Kim et al 22 compared the SVP technique with that of AVP in the insertion of 1,161 pacemaker electrodes.…”

Section: Discussionmentioning

confidence: 99%

Puncture of the Axillary Vein for the Implant for Electronic Cardiac Devices

Pegoraro¹,

Costa²,

Filho³

et al. 2018

J Cardiac Arrhtythmias

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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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Comparison of the Axillary Venous Approach and Subclavian Venous Approach for Efficacy of Permanent Pacemaker Implantation

Cited by 33 publications

References 18 publications

Axillary vein puncture using fluoroscopic landmarks: a safe and effective approach for implantable cardioverter defibrillator leads

Axillary vein puncture using fluoroscopic landmarks: a safe and effective approach for implantable cardioverter defibrillator leads

Predictors of successful ultrasound‐guided lead implantation

Puncture of the Axillary Vein for the Implant for Electronic Cardiac Devices

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