Insights from the axillary vein puncture guided by ultrasound versus cephalic vein dissection trial

2021 ◽  
Author(s):  
Ana Paula Tagliari ◽  
Adriano Nunes Kochi ◽  
Rodrigo Petersen Saadi ◽  
Bernardo Mastella ◽  
Eduardo Keller Saadi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Success Rate ◽  
Randomized Clinical Trial ◽  
Cephalic Vein ◽  
Axillary Vein ◽  
Ultrasound Guided ◽  
Procedural Time

Axillary vein puncture guided by ultrasound (US-Ax) versus cephalic vein dissection in pacemaker and defibrillator implant: a multicenter randomized clinical trial is a recently published study in which 88 patients were randomized in a 1:1 fashion to one of the two methods. Even being performed by operators with not previous ultrasound-guided axillary vein puncture experience, this group presented a higher success rate, lower procedural time and comparable complication incidence.

Assessing ultrasound-guided axillary vein cannulation using a cumulative sum analysis: A single operator experience

2021 ◽  
pp. 112972982110384
Author(s):  
Linjia Zhu ◽  
Chanjuan Gong ◽  
Jinming Zhu ◽  
Lili Zhu ◽  
Liang Chen ◽  
...  
Keyword(s):  
Learning Curve ◽  
Success Rate ◽  
Operating Time ◽  
Axillary Vein ◽  
Ultrasound Guided ◽  
Cumulative Sum ◽  
Operator Experience ◽  
Vein Cannulation ◽  
Cumulative Sum Analysis ◽  
Procedural Time

Background: Ultrasound-guided axillary vein (AxV) cannulation has been described as an effective alternative to internal jugular vein cannulation in adult cardiac surgical patients. However, the learning curve for this technique has not yet been addressed. This study aimed to determine the number of cases required to achieve proficiency in performing AxV cannulation among novice anesthesiologists. Methods: This prospective study included the first 60 patients who underwent ultrasound-guided AxV cannulation performed by a single third-year resident who was trained in adult cardiac anesthesia. This study investigated the number of cases required to gain technical proficiency by applying cumulative sum analysis on the learning curve (LC-CUSUM) of ultrasound-guided AxV cannulation. Results: Based on the assessment of the CUSUM plots, a descending inflection point for decreasing the overall procedural time for AxV cannulation was observed after patient 29. Regarding the procedural outcomes, comparing the early-experience group with the late-experience group (29 vs 31 cases), the former group had longer operating time (1526 s vs 1120 s, p < 0.001) and identification time (110 s vs 92 s, p < 0.001) and lower first-attempt success rate (8, 27.6% vs 30, 96.8%, p < 0.001) than the latter group. Conclusions: CUSUM demonstrated that at least 29 successful cases are required to achieve an expertized manipulation in ultrasound-guided AxV cannulation for inexperienced novices. The learning curve for ultrasound-guided AxV cannulation was observed in 29 cases. After adequate training, the overall procedural time and the first-attempt success rate, and puncture-related complications for AxV cannulation improved with increased experience.

Axillary vein puncture guided by ultrasound vs cephalic vein dissection in pacemaker and defibrillator implant: A multicenter randomized clinical trial

Heart Rhythm ◽  
2020 ◽  
Vol 17 (9) ◽  
pp. 1554-1560 ◽  
Author(s):  
Ana Paula Tagliari ◽  
Adriano Nunes Kochi ◽  
Bernardo Mastella ◽  
Rodrigo Petersen Saadi ◽  
Andres di Leoni Ferrari ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Cephalic Vein ◽  
Axillary Vein

Fluoroscopy‐guided axillary vein access vs cephalic vein access in pacemaker and defibrillator implantation: Randomized clinical trial of efficacy and safety

2019 ◽  
Vol 30 (9) ◽  
pp. 1588-1593 ◽  
Author(s):  
Javier Jiménez‐Díaz ◽  
Felipe Higuera‐Sobrino ◽  
Jesús Piqueras‐Flores ◽  
Pedro Pérez‐Díaz ◽  
María Arantzazu González‐Marín
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Cephalic Vein ◽  
Axillary Vein ◽  
Efficacy And Safety ◽  
Vein Access

scholarly journals A NEW METHOD OF EPISTAXIS MANAGEMENT USING NASAL GEL: A SINGLE CENTER, RANDOMIZED CLINICAL TRIAL

2018 ◽  
Vol 11 (3) ◽  
pp. 104 ◽  
Author(s):  
Mehdi Torabi ◽  
Ava Roughani Esfahani ◽  
Shiva Moeinaddini ◽  
Mohammad Reza Baneshi
Keyword(s):  
Clinical Trial ◽  
Side Effects ◽  
Randomized Clinical Trial ◽  
Patients Satisfaction ◽  
Stop Time ◽  
Common Causes ◽  
Procedural Time ◽  
Nasal Bleeding ◽  
The Common ◽  
Discharge Length

 Objective: Epistaxis is one of the common causes of patients’ referral to the emergency departments. In the majority of cases, epistaxis is managed by traditional methods. We investigated the efficacy of nasal gel (NG) in comparison to anterior nasal packing (ANP) to stop mild-to-moderate anterior nasal bleeding.Methods: In this prospective, randomized clinical trial, patients were divided into two groups of ANP (n=60) and NG (n=40). We determined and compared the efficacy of treatment (bleeding stop time and recurrence), patients’ satisfaction at discharge (length of stay in the hospital, pain during the procedure, and procedural time), and safety (less side effects) in both groups.Results: The procedural time ≤2 min was observed in 90% and 58.33 % of NG group and ANP group, respectively (p<0.001). Pain score during procedure ≤4 and patients’ satisfaction ≥7 were, respectively, seen in 87.5% and 65% of NG group, but it was 43.33% and 41.7% in ANP group, respectively (p<0.001, p=0.02). The side effects in ANP group were 35%; however, no side effects were observed in NG group.Conclusion: In the management of mild-to-moderate anterior nasal bleeding although NG efficacy is equivalent to ANP, using NG may be more convenient and satisfactory for patients. In addition, the use of this gel may result in more safety and fewer side effects.

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