Introduction
CIED
COMPLICATIONS
Venous access is the first and challenging step in lead insertion during implantation of transvenous cardiac implantable electronic devices (CIED) such as pacemakers and implantable cardioverter-defibrillators (ICD). Cephalic vein cutdown (CVC), subclavian vein puncture (SVP), and axillary vein puncture (AVP) are the three principal techniques for venous access.The extra-thoracic position of the axillary vein allows the use of ultrasound (US) guidance, which is recommended in critical care and anaesthesiology to improve success and reduce complications of central venous access.The objective of the randomized controlled ACCESS trial (intra-pocket US-guided axillary vein access vs. CVC for implantation of cardiac electronic devices) was to evaluate the efficacy and the early complications of IPUS-AVP vs. CVC for CIED implantation.