Percutaneous Transaxillary Access for Large-Bore Cardiovascular Interventions: Evidence, Technique, and Complication...

Area of Science:

• Cardiovascular Interventions
• Vascular Access Techniques
• Interventional Cardiology

Background:

• Percutaneous transaxillary access is an alternative to transfemoral access for large-bore arterial procedures.
• It is particularly useful for patients with challenging iliofemoral anatomy.
• This approach facilitates prolonged support and patient mobility during mechanical circulatory support (MCS).

Purpose of the Study:

• To provide a practical framework for percutaneous transaxillary access.
• To summarize clinical evidence, technical aspects, and complication management.
• To offer procedural tips for enhancing safety and reproducibility.

Main Methods:

• Review of contemporary clinical evidence and procedural techniques.
• Emphasis on pre-procedural imaging and patient selection.
• Guidance on ultrasound/angiographic puncture and closure strategies.

Main Results:

• The axillary/subclavian territory presents unique technical and anatomical challenges.
• Meticulous planning, guidance, and closure techniques are crucial.
• Suture-based and balloon-assisted closure methods are key strategies.

Conclusions:

• Percutaneous transaxillary access requires specific expertise due to anatomical challenges.
• Careful patient selection and procedural technique are vital for success.
• This review aims to standardize and improve the safety of the procedure.