Caudal Tilt Ultrasound: Are Things Looking Up for Axillary Vein Access?

The choice of vascular access for transvenous lead implantation must balance ease of vascular access against radiation exposure and risk of procedure-related complications. Although subclavian vein puncture has a well-defined anatomic landmark and enables access to a large caliber vein, it carries risks of pneumothorax, inadvertent arterial puncture, and lead dysfunction due to subclavian crush syndrome. In contrast, cephalic vein cutdown avoids pneumothorax and reduces fluoroscopy through direct visualization of the vein, but is limited by occasional absence of the vein, difficulty passing multiple leads, increased procedural times and risk of pocket hematoma.
Source: Heart Rhythm - Category: Cardiology Authors: Source Type: research