Self-taught axillary vein access without venography for pacemaker implantation : prospective randomized comparison with the cephalic vein access
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For Permissions, please email: journals.permissionsoup.com..
AIM: Axillary vein access for pacemaker implantation is uncommon in many centres because of the lack of training in this technique. We assessed whether the introduction of the axillary vein technique was safe and efficient as compared with cephalic vein access, in a centre where no operators had any previous experience in axillary vein puncture.
METHODS AND RESULTS: Patients undergoing pacemaker implantation were randomized to axillary or cephalic vein access. All three operators had no experience nor training in axillary vein puncture, and self-learned the technique by reading a published review. Axillary vein puncture was fluoroscopy-guided without contrast venography. Cephalic access was performed by dissection of delto-pectoral groove. Venous access success, venous access duration (from skin incision to guidewire or lead in superior vena cava), procedure duration, X-ray exposure, and peri-procedural (1 month) complications were recorded. results We randomized 74 consecutive patients to axillary (n = 37) or cephalic vein access (n = 37). Axillary vein was successfully accessed in 30/37 (81.1%) patients vs. 28/37 (75.7%) of cephalic veins (P = 0.57). Venous access time was shorter in axillary group than in cephalic group [5.7 (4.4-8.3) vs. 12.2 (10.5-14.8) min, P < 0.001], as well as procedure duration [34.8 (30.6-38.4) vs. 42.0 (39.1-46.6) min, P = 0.043]. X-ray exposure and peri-procedural overall complications were comparable in both groups. Axillary puncture was safe and faster than cephalic access even for the five first procedures performed by each operator.
CONCLUSION: Self-taught axillary vein puncture for pacemaker implantation seems immediately safe and faster than cephalic vein access, when performed by electrophysiologists trained to pacemaker implantation but not to axillary vein puncture.
| Errataetall: |
CommentIn: Europace. 2018 Aug 1;20(8):1389-1390. - PMID 29684125 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:19 |
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| Enthalten in: |
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology - 19(2017), 12 vom: 01. Dez., Seite 2001-2006 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Squara, Fabien [VerfasserIn] |
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| Links: |
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| Themen: |
Axillary vein |
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| Anmerkungen: |
Date Completed 30.07.2018 Date Revised 18.03.2022 published: Print CommentIn: Europace. 2018 Aug 1;20(8):1389-1390. - PMID 29684125 Citation Status MEDLINE |
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| doi: |
10.1093/europace/euw363 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM267784228 |
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| 245 | 1 | 0 | |a Self-taught axillary vein access without venography for pacemaker implantation |b prospective randomized comparison with the cephalic vein access |
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| 500 | |a Date Revised 18.03.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Europace. 2018 Aug 1;20(8):1389-1390. - PMID 29684125 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For Permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a AIM: Axillary vein access for pacemaker implantation is uncommon in many centres because of the lack of training in this technique. We assessed whether the introduction of the axillary vein technique was safe and efficient as compared with cephalic vein access, in a centre where no operators had any previous experience in axillary vein puncture | ||
| 520 | |a METHODS AND RESULTS: Patients undergoing pacemaker implantation were randomized to axillary or cephalic vein access. All three operators had no experience nor training in axillary vein puncture, and self-learned the technique by reading a published review. Axillary vein puncture was fluoroscopy-guided without contrast venography. Cephalic access was performed by dissection of delto-pectoral groove. Venous access success, venous access duration (from skin incision to guidewire or lead in superior vena cava), procedure duration, X-ray exposure, and peri-procedural (1 month) complications were recorded. results We randomized 74 consecutive patients to axillary (n = 37) or cephalic vein access (n = 37). Axillary vein was successfully accessed in 30/37 (81.1%) patients vs. 28/37 (75.7%) of cephalic veins (P = 0.57). Venous access time was shorter in axillary group than in cephalic group [5.7 (4.4-8.3) vs. 12.2 (10.5-14.8) min, P < 0.001], as well as procedure duration [34.8 (30.6-38.4) vs. 42.0 (39.1-46.6) min, P = 0.043]. X-ray exposure and peri-procedural overall complications were comparable in both groups. Axillary puncture was safe and faster than cephalic access even for the five first procedures performed by each operator | ||
| 520 | |a CONCLUSION: Self-taught axillary vein puncture for pacemaker implantation seems immediately safe and faster than cephalic vein access, when performed by electrophysiologists trained to pacemaker implantation but not to axillary vein puncture | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Axillary vein | |
| 650 | 4 | |a Cephalic vein | |
| 650 | 4 | |a Pacemaker | |
| 700 | 1 | |a Tomi, Julien |e verfasserin |4 aut | |
| 700 | 1 | |a Scarlatti, Didier |e verfasserin |4 aut | |
| 700 | 1 | |a Theodore, Guillaume |e verfasserin |4 aut | |
| 700 | 1 | |a Moceri, Pamela |e verfasserin |4 aut | |
| 700 | 1 | |a Ferrari, Emile |e verfasserin |4 aut | |
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