Fluoroscopy-guided axillary vein access vs cephalic vein access in pacemaker and defibrillator implantation: Randomized clinical trial of efficacy and safety.

Autor: Jiménez-Díaz J; Arrhythmia Unit, Cardiology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain., Higuera-Sobrino F; Arrhythmia Unit, Cardiology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain., Piqueras-Flores J; Cardiology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain., Pérez-Díaz P; Cardiology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain., González-Marín MA; Cardiology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain.
Jazyk: angličtina
Zdroj: Journal of cardiovascular electrophysiology [J Cardiovasc Electrophysiol] 2019 Sep; Vol. 30 (9), pp. 1588-1593. Date of Electronic Publication: 2019 Jul 23.
DOI: 10.1111/jce.14060
Abstrakt: Introduction: The most widespread venous sites of access for implantation intravenous implantable cardiac electronic device (CIED) are the cephalic and subclavian vein. Fluoroscopy-guided axillary venous access is an alternative, but efficacy and safety have not been studied under equal conditions. The aim of the present study is to compare the efficacy and safety of fluoroscopy-guided axillary vs cephalic vein access in CIED implant.
Methods and Results: Two hundred and forty patients were randomized to receive CIED implantation by the fluoroscopy-guided axillary vein access vs cephalic vein access. The implantation success, the procedure times and the complications were recorded. A comparison of the results of operators was made. The success rate of the randomized venous access was superior in the axillary group than in cephalic (98.3% vs 76.7%, P < .001). Time to access (6.8 ± 3.1 minute vs 13.1 ± 5.8 minutes, P < .001) and implantation duration was significantly shorter in the axillary group than in the cephalic group (42.3 ± 11.6 minutes vs 50.5 ± 13.3 minutes, P < .001). There was no difference in the incidence of complication and inter-operator success rate, complications rate and time to access.
Conclusion: The fluoroscopy-guided axillary venous access is safe and has a better success rate and faster execution time compared with the cephalic vein access. When the results were compared among the study operators, neither in the axillary nor in the cephalic group there were differences in the success rate, the complication rate, and the time to access.
Trial Registration: www.clinicaltrials.gov, NCT03860090.
(© 2019 Wiley Periodicals, Inc.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje