Open AccessUltrasound-guided Axillary Vein Puncture in Cardiac Lead Implantation: Time to Move to a New Standard Access?
Author(s) -
Ana Paula Tagliari,
Adriano Nunes Kochi,
Bernardo Mastella,
Rodrigo Petersen Saadi,
Andrés Di Leoni Ferrari,
Luiz Henrique Dussin,
Leandro de Moura,
Márcio Rodrigo Martins,
Eduardo Keller Saadi,
Carísi Anne Polanczyk
Publication year - 2020
Publication title -
arrhythmia and electrophysiology review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.008
H-Index - 18
eISSN - 2050-3377
pISSN - 2050-3369
DOI - 10.15420/aer.2020.17
Subject(s) - medicine , axillary vein , fluoroscopy , cephalic vein , subclavian vein , venography , context (archaeology) , surgery , implant , radiology , vein , catheter , thrombosis , paleontology , biology
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.