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The Lead Episode 34: Intra-Pocket Ultrasound-Guided Axillary Vein Puncture vs. Cephalic Vein Cutdown for Cardiac Electronic Device Implantation: The ACCESS Trial
Description
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.
Learning Objectives
  • To understand the differences in venous access techniques for intravascular lead implantation.
Article Authors and Podcast Contributors
Article Authors
Paul Charles, Geoffroy Ditac, Mathieu Montoy, Thibaut Thenard, Pierre-Yves Courand, Pierre Lantelme, Brahim Harbaoui, Samir Fareh

Podcast Contributors
William H. Sauer, MD, FHRS, CCDS, of Brigham and Women's Hospital
Sunil Kapur, MD, of Brigham and Women's Hospital
Joshua M. Cooper, MD, FHRS, of Temple University Health System
Disclosures

 

All relevant financial relationships have been mitigated.

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

Staff Disclosure(s) (note: HRS staff are NOT in control of educational content. Disclosures are provided solely for full transparency to the learner):
J. Glenn: No relevant financial relationships with ineligible companies to disclose. 
S. Sailor: No relevant financial relationships with ineligible companies to disclose.
Summary
Availability:
On-Demand
Cost:
FREE
Credit Offered:
No Credit Offered
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