Blind axillar venous access

Area of Science:

• Vascular Access
• Cardiovascular Procedures
• Anatomy

Background:

• The subclavian crush phenomenon can complicate central venous access.
• Alternative venous access sites are needed to mitigate this complication.
• The axillary vein is a potential alternative for venous access.

Purpose of the Study:

• To evaluate a simple anatomical landmark-guided technique for axillary vein access.
• To assess the safety and efficacy of axillary vein cannulation for pacemaker and ICD procedures.

Main Methods:

• A blind venous cannulation technique using the deltopectoral groove as the primary anatomical landmark.
• Application in 168 consecutive pacemaker and implantable cardioverter-defibrillator (ICD) procedures.
• Documentation of success rates and failures requiring alternative approaches.

Main Results:

• The technique was successful in 165 out of 168 procedures (98.2% success rate).
• Only three cases (1.8%) required an alternative venous access approach.
• No major complications were reported related to the axillary vein access itself.

Conclusions:

• A simple, anatomy-guided blind stick technique for axillary vein access is highly effective.
• The axillary vein can be safely utilized as a primary venous access site, particularly to avoid the subclavian crush phenomenon.
• Thorough anatomical knowledge is key to successful and safe axillary vein cannulation.