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Percutaneous axillary access for large-bore arteriotomy: A step-by-step guide.
Ahmad Hallak1, Lawrence Wei2, Chalak Berzingi1
1Division of Cardiology, West Virginia University, Morgantown, West Virginia.
Journal of Cardiac Surgery
|April 27, 2018
Summary
Transcatheter cardiovascular interventions increasingly need large-bore access. Percutaneous axillary access offers a viable alternative for patients unsuitable for traditional femoral approaches, detailed in this guide.
Area of Science:
- Cardiovascular medicine
- Interventional cardiology
- Vascular surgery
Background:
- Transcatheter cardiovascular interventions have rapidly advanced, demanding large-bore vascular access.
- The common femoral artery is the primary access route, but patient anatomy can preclude its use.
- Alternative access sites are crucial for expanding the reach of these life-saving procedures.
Observation:
- A significant patient subset cannot undergo transfemoral access due to conditions like peripheral artery disease or small vessel diameters.
- Percutaneous axillary artery access presents a practical alternative for achieving large-bore access in challenging cases.
- This technique facilitates complex transcatheter procedures when femoral access is not feasible.
Findings:
- The study outlines a detailed, step-by-step methodology for performing percutaneous large-bore access via the axillary artery.
- The guide covers essential techniques for successful access and subsequent vascular closure.
- This approach enables the safe delivery of large-caliber devices for various transcatheter interventions.
Implications:
- Percutaneous axillary access expands treatment options for patients needing complex transcatheter cardiovascular interventions.
- It provides a critical solution for individuals with inadequate femoral vasculature.
- This technique enhances the applicability and success rates of advanced cardiovascular therapies.
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