Ultrasound-guided axillary vein puncture for cardiac devices implantation in patients under antithrombotic therapy
Background: Ultrasound-guided axillary venous puncture (UGAVP) for cardiac devices implantation has been developed because of its rapidity, safety and potential long-term lead protection. Early work excluded defibrillators (ICD), cardiac resynchronization therapy (CRT) and upgrade procedures. Compar...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-01-01
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| Series: | Indian Pacing and Electrophysiology Journal |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0972629219301470 |
| _version_ | 1811337200251437056 |
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| author | Mohammed ElJamili Sok-Sithikun Bun Decebal Gabriel Latcu Tahar Delassi Mustapha Elhattaoui Nadir Saoudi |
| author_facet | Mohammed ElJamili Sok-Sithikun Bun Decebal Gabriel Latcu Tahar Delassi Mustapha Elhattaoui Nadir Saoudi |
| author_sort | Mohammed ElJamili |
| collection | DOAJ |
| description | Background: Ultrasound-guided axillary venous puncture (UGAVP) for cardiac devices implantation has been developed because of its rapidity, safety and potential long-term lead protection. Early work excluded defibrillators (ICD), cardiac resynchronization therapy (CRT) and upgrade procedures. Compared to the cephalic approach, in previous studies, there was a greater use of pressure dressings with this technique, suggesting a higher risk of bleeding. Aims: To assess UGAVP in patients under antithrombotic therapy (ATT) undergoing cardiac devices implantation including CRT/ICD. Methods: Prospectively, consecutive patients eligible for a pacemaker or ICD implantation were included. All procedures were performed by a single operator, experienced with UGAVP for femoral access, and fluoroscopy-guided axillary vein access. Guidewires insertion time (from lidocaïne administration), and complications were systematically studied. Results: From 457 cardiac device implantations, 200 patients (77.8 ± 10 y, male 58%) 360 leads were implanted by UGAVP including 36 ICD, 54 CRT and 14 upgrade procedures. A majority (90%) was under ATT: Vitamin K Antagonist or Heparin (n = 58, 29%), direct oral anticoagulant (n = 46, 23%), dual antithrombotic therapy (n = 18, 9%) and single antiplatelet drug (n = 82, 41%). UGAVP was successful in 95.78%. Mean insertion time for 1.8 guidewires per patient was 4.68 ± 3.6 min. No complication (no hematoma) was observed during the follow-up (mean of 45 ± 10 months). Guidewires insertion time reached its plateau after 15 patients. Conclusion: UGAVP is fast, feasible and safe for patients under ATT undergoing device implantation including CRT/ICD and upgrade procedures, with a short learning curve. Keywords: Cardiac devices implantation, Vascular complications, Ultrasound guidance, Antithrombotic therapy |
| first_indexed | 2024-04-13T17:51:37Z |
| format | Article |
| id | doaj.art-8d755906cd1444e39fb2cefe7ea762b2 |
| institution | Directory Open Access Journal |
| issn | 0972-6292 |
| language | English |
| last_indexed | 2024-04-13T17:51:37Z |
| publishDate | 2020-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Pacing and Electrophysiology Journal |
| spelling | doaj.art-8d755906cd1444e39fb2cefe7ea762b22022-12-22T02:36:42ZengElsevierIndian Pacing and Electrophysiology Journal0972-62922020-01-012012126Ultrasound-guided axillary vein puncture for cardiac devices implantation in patients under antithrombotic therapyMohammed ElJamili0Sok-Sithikun Bun1Decebal Gabriel Latcu2Tahar Delassi3Mustapha Elhattaoui4Nadir Saoudi5Department of Cardiology, University Hospital Mohammed VI, Marrakech, Morocco; Department of Cardiology, Princess Grace Hospital, Monaco, France; Corresponding author. Department of Cardiology, University Hospital Mohammed VI, Marrakech, Morocco.Department of Cardiology, Princess Grace Hospital, Monaco, FranceDepartment of Cardiology, Princess Grace Hospital, Monaco, FranceDepartment of Cardiology, Princess Grace Hospital, Monaco, FranceDepartment of Cardiology, University Hospital Mohammed VI, Marrakech, MoroccoDepartment of Cardiology, Princess Grace Hospital, Monaco, FranceBackground: Ultrasound-guided axillary venous puncture (UGAVP) for cardiac devices implantation has been developed because of its rapidity, safety and potential long-term lead protection. Early work excluded defibrillators (ICD), cardiac resynchronization therapy (CRT) and upgrade procedures. Compared to the cephalic approach, in previous studies, there was a greater use of pressure dressings with this technique, suggesting a higher risk of bleeding. Aims: To assess UGAVP in patients under antithrombotic therapy (ATT) undergoing cardiac devices implantation including CRT/ICD. Methods: Prospectively, consecutive patients eligible for a pacemaker or ICD implantation were included. All procedures were performed by a single operator, experienced with UGAVP for femoral access, and fluoroscopy-guided axillary vein access. Guidewires insertion time (from lidocaïne administration), and complications were systematically studied. Results: From 457 cardiac device implantations, 200 patients (77.8 ± 10 y, male 58%) 360 leads were implanted by UGAVP including 36 ICD, 54 CRT and 14 upgrade procedures. A majority (90%) was under ATT: Vitamin K Antagonist or Heparin (n = 58, 29%), direct oral anticoagulant (n = 46, 23%), dual antithrombotic therapy (n = 18, 9%) and single antiplatelet drug (n = 82, 41%). UGAVP was successful in 95.78%. Mean insertion time for 1.8 guidewires per patient was 4.68 ± 3.6 min. No complication (no hematoma) was observed during the follow-up (mean of 45 ± 10 months). Guidewires insertion time reached its plateau after 15 patients. Conclusion: UGAVP is fast, feasible and safe for patients under ATT undergoing device implantation including CRT/ICD and upgrade procedures, with a short learning curve. Keywords: Cardiac devices implantation, Vascular complications, Ultrasound guidance, Antithrombotic therapyhttp://www.sciencedirect.com/science/article/pii/S0972629219301470 |
| spellingShingle | Mohammed ElJamili Sok-Sithikun Bun Decebal Gabriel Latcu Tahar Delassi Mustapha Elhattaoui Nadir Saoudi Ultrasound-guided axillary vein puncture for cardiac devices implantation in patients under antithrombotic therapy Indian Pacing and Electrophysiology Journal |
| title | Ultrasound-guided axillary vein puncture for cardiac devices implantation in patients under antithrombotic therapy |
| title_full | Ultrasound-guided axillary vein puncture for cardiac devices implantation in patients under antithrombotic therapy |
| title_fullStr | Ultrasound-guided axillary vein puncture for cardiac devices implantation in patients under antithrombotic therapy |
| title_full_unstemmed | Ultrasound-guided axillary vein puncture for cardiac devices implantation in patients under antithrombotic therapy |
| title_short | Ultrasound-guided axillary vein puncture for cardiac devices implantation in patients under antithrombotic therapy |
| title_sort | ultrasound guided axillary vein puncture for cardiac devices implantation in patients under antithrombotic therapy |
| url | http://www.sciencedirect.com/science/article/pii/S0972629219301470 |
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