Arrhythmias & electrophysiologyMeta-analysis
Ultrasound-guided vs. fluoro-guided axillary venous access for cardiac implantable electronic devices: a patient-based meta-analysis
- Individual patient data meta-analysis
- 5 RCTs and 1 prospective study
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 patients · 6 studies
- Comparison
- US-guided axillary venous puncture vs fluoroscopy-guided access
- Outcome
- Safety of the two techniques
Pooled result
Inadvertent arterial puncture
Odds ratio
2.15
95% CI 2.10–2.21
P = 0.003
X-ray-guided vs 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
Summarised from the published abstract; every number is checked against it