William H. Sauer, MD, FHRS, CCDS, of Brigham and Women's Hospital is joined by guests Sunil Kapur, MD, of Brigham and Women's Hospital, and Joshua M. Cooper, MD, FHRS, of Temple University Health System to discuss Intra-Pocket Ultrasound-Guided Axillary Vein Puncture vs. Cephalic Vein Cutdown for Cardiac Electronic Device Implantation: The ACCESS Trial. Intra-pocket ultrasound-guided axillary vein puncture (IPUS-AVP) for venous access in implantation of transvenous cardiac implantable electronic devices (CIED) is uncommon due to the lack of clinical evidence supporting this technique. This study investigated the efficacy and early complications of IPUS-AVP compared to the standard method using cephalic vein cutdown (CVC) for CIED implantation. IPUS-AVP is superior to CVC in terms of success rate, time to venous access, procedure duration, and radiation exposure. Complication rates were similar between the two groups. Intra-pocket ultrasound-guided axillary vein puncture should be a recommended venous access technique for CIED implantation.

https://www.hrsonline.org/education/TheLead

https://pubmed.ncbi.nlm.nih.gov/37832512/

https://pubmed.ncbi.nlm.nih.gov/37378419/

Host Disclosure(s):

W. Sauer: Honoraria/Speaking/Consulting Fee: Biotronik, Biosense Webster, Inc., Abbott, Boston Scientific; Research (Contracted Grants for PIs Named Investigators Only): Medtronic

Contributor Disclosure(s):

S. Kapur: Honoraria/Speaking/Consulting Fee: Medtronic, Novartis, Abbott, Biotronik

J. Cooper: Honoraria/Speaking/Consulting Fee: Medtronic, Biosense Webster, Inc., Abbott, Boston Scientific, Medical Device Business Services, Zoll Medical Company