A modified approach for ultrasound-guided axillary venipuncture in the infraclavicular area: A retrospective observational study

Yao, Minmin; Xiong, Wanxia; Xu, Li; Gao, Feng

doi:10.1177/1129729819838135

Cited by 2 publications

(1 citation statement)

References 23 publications

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“…This is not the case. 23 , 24 Ultrasound guidance is easily learnt and works in almost every patient. 8 , 20 , 25 There are multiple videos on the internet to demonstrate appropriate techniques and pitfalls.…”

Section: Is Ultrasound Guidance Difficult?mentioning

confidence: 99%

Axillary vein access using ultrasound guidance, Venography or Cephalic Cutdown—What is the optimal access technique for insertion of pacing leads?

Davis

Chik

Kumar

et al. 2021

Journal of Arrhythmia

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Cardiac Implantable Electronic Device implantation is associated with a small risk for pocket hematoma partially due to inadvertent axillary/subclavian artery puncture, pneumothorax and infection and more rarely thoracic duct injury and brachial plexus injury and in the long term lead fracture. 1 The traditional anatomic based approach for subclavian vein puncture is particularly associated with an increased risk. 2,3 These risks could be reduced by accessing the axillary vein and not the subclavian vein using a venogram based approach, [4][5][6][7] or by an ultrasound based approach for lead insertion 4,[6][7][8] or cephalic vein cut down. [4][5][6][7] Most implanters prefer cephalic cutdown as their initial approach. 9 We argue that an ultrasound guided axillary vein approach also should be considered for all such procedures. | CEPHALI C VEIN CUTDOWNCephalic cutdown has been suggested to be the preferred venous access to reduce the risk for lead crush and to avoid needle stick injury to surrounding structures. 10 However it is only suitable for some patients 11 due to small vein size, tortuosity, difficulty surgically isolating the vein and in some cases vein absence. 10 It is approached with surgical dissection of the deltopectoral groove, the vein lying between the pectoralis major and deltoid muscles (Figure 1). The vein is blunt dissected free from the surrounding structures and cannulated either with an intravenous (IV) cannula and glidewire or venotomy, a vein pick and then passage of a wire or lead down the vein lumen. In some cases, venography also is

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