Int J Arrhythm.  2024 Sep;25(3):19. 10.1186/s42444-024-00125-6.

Feasibility of ultrasound‑guided axillary vein access for implantation of cardiac implantable electronic device leads

• Oh S
•  Hwang J
• Park H
• Chung T
• Jung M

• KMID: 2559706
• DOI: http://doi.org/10.1186/s42444-024-00125-6

Abstract

Background
The axillary vein is preferred over the subclavian vein, and the cephalic vein for cardiac implantable electronic device (CIED) lead insertion. However, studies on ultrasound-guided axillary vein access (US-AVA) in Asia are scarce. This study aims to evaluate the feasibility of US-AVA for CIED lead implantation in Korean patients.
Methods
From September 2021 to September 2023, we employed US-AVA for CIED lead implantation procedures. Patients’ demographic and procedural data were collected and analyzed retrospectively.
Results
US-AVA was successful in 301 patients (97.7%). There were no occurrences of pneumothorax or severe hematoma due to inadvertent arterial puncture, nor were there any other significant vascular access-related acute complications. During the median 1.7 years of follow-up, no CIED infection or lead-related problems have occurred. Compared to a historical cohort of patients who underwent fluoroscopy-guided axillary vein access (FL-AVA), US-AVA significantly reduced procedure and fluoroscopy time and showed a trend toward reduced radiation doses.
Conclusion
US-AVA is a safe and effective technique for CIED lead implantation in Korean patients, with advantages over FL-AVA in terms of procedural efficiency and patient safety.

Keyword

Ultrasound; Axillary vein; Cephalic vein; Cardiac implantable electronic device; Pacemaker; Implantable cardioverter-defibrillator; Cardiac resynchronization therapy