IMR Press / RCM / Volume 23 / Issue 8 / DOI: 10.31083/j.rcm2308258
Open Access Original Research
The Use of a Handheld Ultrasound Device to Guide the Axillary Vein Access during Pacemaker and Cardioverter-Defibrillator Implantation. A Feasibility Study
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1 Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
2 Department of Emergency, Division of Cardiology, Annunziata Hospital, Azienda Unità Sanitaria Locale di Ferrara, 44042 Cento, Ferrara, Italy
3 Department of Emergency, Division of Cardiology, Delta Hospital, Azienda Unità Sanitaria Locale di Ferrara, 44023 Lagosanto, Ferrara, Italy
4 Cardiothoracic Department, Udine Civil Hospital, 33100 Udine, Italy
*Correspondence: (Biagio Sassone)
Academic Editor: Jerome L. Fleg
Rev. Cardiovasc. Med. 2022, 23(8), 258;
Submitted: 10 February 2022 | Revised: 11 June 2022 | Accepted: 15 June 2022 | Published: 20 July 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: Although ultrasound guidance for axillary vein (AV) access (USGAVA) has been described as a reliable technique for cardiac implantable electronic device (CIED) implantation, no data is available on the use of handheld ultrasound devices (HUD) in such a setting. Objective: We investigated the feasibility of using a HUD for USGAVA in patients referred to our Institution for CIED implantation. Methods: The procedure details of 80 consecutive patients undergoing USGAVA (Group-1) from June 2020 to June 2021 were prospectively collected and compared to those of an age and sex-matched cohort of 91 patients (Group-2) who had undergone AV access with the traditional venipuncture guided by fluoroscopic landmarks. Results: The two groups were comparable for the success rate of venous access (92.5% versus 93.4%, p = 0.82), complication rate (1.3% versus 0.9%, p = 1.0), and procedure time (71 ± 32 min versus 70 ± 29 min, p = 0.9). However, Group-2 had a longer X-ray exposure time (7.6 ± 8.4 min versus 5.7 ± 7.3 min, p = 0.03). In Group-1, the univariate logistic regression analysis demonstrated that the AV diameter was associated with successful USGAVA (odds ratio = 3.34, 95% confidence interval 1.47–7.59, p < 0.01), with a 3-fold increase of probability of success per each 1 mm increase in the AV diameter. Conclusions: USGAVA using a HUD for CIED implantation is a feasible, effective, and safe technique; moreover, it saves X-ray exposure time without lengthening the implant procedure time.

axillary vein
Fig. 1.
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