A comparison of longitudinal and transverse approaches to ultrasound-guided axillary vein cannulation by experienced operators

He, Yizhou Joseph; Zhong, Ming; Wu, Wei; Song, Jieqiong; Zhu, Dexiang

doi:10.21037/jtd.2017.03.137

Cited by 10 publications

(8 citation statements)

References 26 publications

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“…After timeout, intravenous fluids were provided in the ipsilateral arm as implant at 999 ml/hour until venous access was obtained unless there was a contraindication such as heart failure or elevated venous pressure. A wireless US transceiver (Siemens Acuson Freestyle with L8‐3 transducer) was used to obtain imaging in a longitudinal fashion 19 (Figure 1) with identification of the axillary artery superiorly and the axillary vein inferiorly. The US depth was adjusted to facilitate optimal axillary vein visualization.…”

Section: Methodsmentioning

confidence: 99%

Ultrasound guided axillary vein access: An alternative approach to venous access for cardiac device implantation

Chandler

Apte

Ranka

et al. 2021

Cardiovasc electrophysiol

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Introduction Ultrasound guided axillary vein access (UGAVA) is an emerging approach for cardiac implantable electronic device (CIED) implantation not widely utilized. Methods and Results This is a retrospective, age and sex‐matched cohort study of CIED implantation from January 2017 to July 2019 comparing UGAVA before incision to venous access obtained after incision without ultrasound (conventional). The study population included 561 patients (187 with attempted UGAVA, 68 ± 13 years old, 43% women, body mass index (BMI) 30 ± 8 kg/m2, 15% right‐sided, 43% implantable cardioverter‐defibrillator, 15% upgrades). UGAVA was successful in 178/187 patients (95%). In nine patients where UGAVA was abandoned, the vein was too deep for access before incision. BMI was higher in abandoned patients than successful UGAVA (38 ± 6 vs. 28 ± 6 kg/m2, p < .0001). Median time from local anesthetic to completion of UGAVA was 7 min (interquartile range [IQR]: 4–10) and median procedure time 61 min (IQR: 50–92). UGAVA changed implant laterality in two patients (avoiding an extra incision in both) and could have prevented unnecessary incision in four conventional patients. Excluding device upgrades, there was reduced fluoroscopy time in UGAVA versus conventional (4 vs. 6 min; IQR: 2–5 vs. 4–9; p < .001). Thirty‐day complications were similar in UGAVA versus conventional (n = 7 vs. 26, 4 vs. 7%; p = .13, p = .41 adjusting for upgrades), partly driven by a trend towards reduced pneumothorax (n = 0 vs. 3, 0 vs. 1%; p = .22). Conclusions UGAVA is a safe approach for CIED implantation and helps prevent an extra incision if a barrier is identified changing laterality preincision.

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Section: Methodsmentioning

confidence: 99%

Ultrasound guided axillary vein access: An alternative approach to venous access for cardiac device implantation

Chandler

Apte

Ranka

et al. 2021

Cardiovasc electrophysiol

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“…On the contrary, only the needle's cross section is visualized in transverse imaging. The time required in longitudinal imaging technique may be longer, 25 though it has not been compared with transverse imaging in caudal blocks. The time taken for preparation of the ultrasound probe and scan time was also not measured in any study.…”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of landmark technique and ultrasound‐guided caudal epidural injection in pediatric population: A systematic review and meta‐analysis

Jain

Hussain

Ayub

2021

Pediatric Anesthesia

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Caudal epidural block is a common regional anesthesia technique for lower limb and infraumbilical surgeries in children. 1 It makes up to 40% of all regional anesthesia blocks and more than 90% of single injection and 25% of continuous catheter neuraxial blocks in the pediatric age group. 2 The caudal block is highly popular in children because of multiple reasons. Firstly, the epidural space is easy to access due to non-ossification of ligaments. The spread of local anesthetic may be facilitated by fluidity of epidural fat and loose attachment of fascia to nerves. 3 The chance of dural puncture is also decreased as the dural sac ends well above the site of the sacral

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“…They reported few complications as malposition (13.4%); pneumothorax (0.5%) and axillary artery puncture occurred in 5 (2.5%) patients. In their retrospective study that included 236 patients, who had undergone AXV cannulation, He YZ et al (10) compared the rates of successful needle puncture and mechanical complications between procedures performed through long-and short-axis views. They reported higher first attempt success rate in long (91.7%) than short (82.8%) axis view.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided infraclavicular axillary vein cannulation: - is it a good alternative to internal jugular vein in pediatric cardiac surgery?

Elbaser¹,

Abdelmageed²,

Elmorsy³

2021

jarss

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INTRODUCTION: This study was designed to compare the rate of successful first attempt and mechanical complications between internal jugular vein (IJV) and axillary vein (AXV) cannulation. METHODS: This prospective, randomized, comparative, controlled study included 220 pediatric patients with age range 1 to 12 years admitted for cardiac surgery. Patients were allocated into 2 equal groups, IJV group and AXV group. The main collected data were the rate of successful first, second and third punctures attempts and the rate of mechanical complications (arterial puncture, pneumothorax, catheter occlusion, catheter malposition, nerve injury). RESULTS: There was no statistically significant difference (P=0.053) in the first skin puncture success rate in both groups (AXV group 80% and IJV group 68%). There were no significant differences as regard the second and third skin punctures success rates. The incidence of failed vein puncture was similar (P=1.000) in IJV (3%) and AXV (2%) groups. The vein puncture and catheter insertion times were comparable in both groups. The rates of arterial puncture, pneumothorax and catheter malposition were similar in IJV and AXV groups (12% vs 11%, 4% vs 1%, 3% vs 5% respectively). Catheter occlusion with sternal retraction was significantly higher (p=0.029) in AXV than IJV group (6% vs 0%). No patient developed postoperative phrenic (IJV group) or brachial plexus nerve injury (AXV group). DISCUSSION AND CONCLUSION: Ultrasound-guided cannulation of both infraclavicular AXV and IJV were similarly associated with high success rate and low incidence of mechanical complications.

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A comparison of longitudinal and transverse approaches to ultrasound-guided axillary vein cannulation by experienced operators

Cited by 10 publications

References 26 publications

Ultrasound guided axillary vein access: An alternative approach to venous access for cardiac device implantation

Ultrasound guided axillary vein access: An alternative approach to venous access for cardiac device implantation

Comparative evaluation of landmark technique and ultrasound‐guided caudal epidural injection in pediatric population: A systematic review and meta‐analysis

Ultrasound-guided infraclavicular axillary vein cannulation: - is it a good alternative to internal jugular vein in pediatric cardiac surgery?

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