Arrhythmias & electrophysiology

Ultrasound-guided vs. fluoro-guided axillary venous access for cardiac implantable electronic devices: a patient-based meta-analysis

EuropacePublished Individual patient data meta-analysis

Pooled result · Inadvertent arterial punctureResult — go to the resultOdds ratio 2.15 95% CI 2.10–2.21

Authors' conclusion

The US-AVP enhances safety by reducing radiation exposure and time to vascular access while maintaining a low rate of major complications compared to the X-ray-guided approach.

Study context

Population
Patients undergoing cardiac implantable electronic device (CIED) procedures
Participants
700 patients6 studies
Comparison
US-guided axillary venous puncture vs fluoroscopy-guided access
Outcome
Safety of the two techniques
Methodological details5 RCTs and 1 prospective study
  • 5 RCTs and 1 prospective study

Pooled result

Inadvertent arterial puncture

Odds ratio

2.15

95% CI 2.10–2.21

P = 0.003

X-ray-guidedvs US-AVP
OR 2.15 (95% CI 2.10–2.21); P = 0.003

As reported in the abstract

Further pooled results

Success rate of venous cannulation

Similar success rate with the two approaches

Time to vascular access, radiation exposure, number of attempts

Reduced with US-AVP

Original publication

Ultrasound-guided vs. fluoro-guided axillary venous access for cardiac implantable electronic devices: a patient-based meta-analysis. Europace. Published 29 October 2024. doi:10.1093/europace/euae274

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