Sassone Biagio, Simeti Giuseppe, Virzì Santo, Pasanisi Giovanni, Muser Daniele
Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy.
Department of Emergency, Division of Cardiology, SS.ma Annunziata Hospital, Azienda Unità Sanitaria Locale di Ferrara, 44042 Cento, Ferrara, Italy.
Rev Cardiovasc Med. 2022 Jul 20;23(8):258. doi: 10.31083/j.rcm2308258. eCollection 2022 Aug.
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.
We investigated the feasibility of using a HUD for USGAVA in patients referred to our Institution for CIED implantation.
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.
The two groups were comparable for the success rate of venous access (92.5% versus 93.4%, = 0.82), complication rate (1.3% versus 0.9%, = 1.0), and procedure time (71 32 min versus 70 29 min, = 0.9). However, Group-2 had a longer X-ray exposure time (7.6 8.4 min versus 5.7 7.3 min, = 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, 0.01), with a 3-fold increase of probability of success per each 1 mm increase in the AV diameter.
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.
尽管超声引导下腋静脉穿刺（USGAVA）已被描述为心脏植入式电子设备（CIED）植入的可靠技术，但在这种情况下使用手持式超声设备（HUD）的数据尚不可用。
我们研究了在我院接受CIED植入的患者中使用HUD进行USGAVA的可行性。
前瞻性收集2020年6月至2021年6月连续80例行USGAVA的患者（第1组）的手术细节，并与91例年龄和性别匹配、通过透视标志引导下传统静脉穿刺进行腋静脉穿刺的患者（第2组）进行比较。
两组在静脉穿刺成功率（92.5%对93.4%，P = 0.82）、并发症发生率（1.3%对0.9%，P = 1.0）和手术时间（71±32分钟对70±29分钟，P = 0.9）方面具有可比性。然而，第2组的X线暴露时间更长（7.6±8.4分钟对5.7±7.3分钟，P = 0.03）。在第1组中，单因素逻辑回归分析表明腋静脉直径与USGAVA成功相关（优势比 = 3.34，95%置信区间1.47 - 7.59，P = 0.01），腋静脉直径每增加1mm，成功概率增加3倍。
使用HUD进行CIED植入的USGAVA是一种可行、有效且安全的技术；此外，它可节省X线暴露时间，且不延长植入手术时间。
