Ultrasound-guided axillary vein puncture for cardiac devices implantation in patients under antithrombotic therapy
Copyright © 2019 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. All rights reserved..
BACKGROUND: Ultrasound-guided axillary venous puncture (UGAVP) for cardiac devices implantation has been developed because of its rapidity, safety and potential long-term lead protection. Early work excluded defibrillators (ICD), cardiac resynchronization therapy (CRT) and upgrade procedures. Compared to the cephalic approach, in previous studies, there was a greater use of pressure dressings with this technique, suggesting a higher risk of bleeding.
AIMS: To assess UGAVP in patients under antithrombotic therapy (ATT) undergoing cardiac devices implantation including CRT/ICD.
METHODS: Prospectively, consecutive patients eligible for a pacemaker or ICD implantation were included. All procedures were performed by a single operator, experienced with UGAVP for femoral access, and fluoroscopy-guided axillary vein access. Guidewires insertion time (from lidocaïne administration), and complications were systematically studied.
RESULTS: From 457 cardiac device implantations, 200 patients (77.8 ± 10 y, male 58%) 360 leads were implanted by UGAVP including 36 ICD, 54 CRT and 14 upgrade procedures. A majority (90%) was under ATT: Vitamin K Antagonist or Heparin (n = 58, 29%), direct oral anticoagulant (n = 46, 23%), dual antithrombotic therapy (n = 18, 9%) and single antiplatelet drug (n = 82, 41%). UGAVP was successful in 95.78%. Mean insertion time for 1.8 guidewires per patient was 4.68 ± 3.6 min. No complication (no hematoma) was observed during the follow-up (mean of 45 ± 10 months). Guidewires insertion time reached its plateau after 15 patients.
CONCLUSION: UGAVP is fast, feasible and safe for patients under ATT undergoing device implantation including CRT/ICD and upgrade procedures, with a short learning curve.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:20 |
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| Enthalten in: |
Indian pacing and electrophysiology journal - 20(2020), 1 vom: 01. Jan., Seite 21-26 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
ElJamili, Mohammed [VerfasserIn] |
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| Links: |
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| Themen: |
Antithrombotic therapy |
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| Anmerkungen: |
Date Revised 10.01.2021 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.ipej.2019.12.008 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM304578002 |
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| 500 | |a Date Revised 10.01.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright © 2019 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. All rights reserved. | ||
| 520 | |a BACKGROUND: Ultrasound-guided axillary venous puncture (UGAVP) for cardiac devices implantation has been developed because of its rapidity, safety and potential long-term lead protection. Early work excluded defibrillators (ICD), cardiac resynchronization therapy (CRT) and upgrade procedures. Compared to the cephalic approach, in previous studies, there was a greater use of pressure dressings with this technique, suggesting a higher risk of bleeding | ||
| 520 | |a AIMS: To assess UGAVP in patients under antithrombotic therapy (ATT) undergoing cardiac devices implantation including CRT/ICD | ||
| 520 | |a METHODS: Prospectively, consecutive patients eligible for a pacemaker or ICD implantation were included. All procedures were performed by a single operator, experienced with UGAVP for femoral access, and fluoroscopy-guided axillary vein access. Guidewires insertion time (from lidocaïne administration), and complications were systematically studied | ||
| 520 | |a RESULTS: From 457 cardiac device implantations, 200 patients (77.8 ± 10 y, male 58%) 360 leads were implanted by UGAVP including 36 ICD, 54 CRT and 14 upgrade procedures. A majority (90%) was under ATT: Vitamin K Antagonist or Heparin (n = 58, 29%), direct oral anticoagulant (n = 46, 23%), dual antithrombotic therapy (n = 18, 9%) and single antiplatelet drug (n = 82, 41%). UGAVP was successful in 95.78%. Mean insertion time for 1.8 guidewires per patient was 4.68 ± 3.6 min. No complication (no hematoma) was observed during the follow-up (mean of 45 ± 10 months). Guidewires insertion time reached its plateau after 15 patients | ||
| 520 | |a CONCLUSION: UGAVP is fast, feasible and safe for patients under ATT undergoing device implantation including CRT/ICD and upgrade procedures, with a short learning curve | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Antithrombotic therapy | |
| 650 | 4 | |a Cardiac devices implantation | |
| 650 | 4 | |a Ultrasound guidance | |
| 650 | 4 | |a Vascular complications | |
| 700 | 1 | |a Bun, Sok-Sithikun |e verfasserin |4 aut | |
| 700 | 1 | |a Latcu, Decebal Gabriel |e verfasserin |4 aut | |
| 700 | 1 | |a Delassi, Tahar |e verfasserin |4 aut | |
| 700 | 1 | |a Elhattaoui, Mustapha |e verfasserin |4 aut | |
| 700 | 1 | |a Saoudi, Nadir |e verfasserin |4 aut | |
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