1074 AXILLARY VEIN PUNCTURE VERSUS CEPHALIC VEIN CUTDOWN FOR CARDIAC IMPLANTABLE ELECTRONIC DEVICE IMPLANTATION: A METANALYSIS

Abstract Introduction Transvenous lead implantation for pacemaker is commonly performed by the cephalic vein cutdown (CVC), subclavian (SVP), or axillary puncture (AVP)(1). However, CVC AVP should be considered as first choice, according to last guidelines, due high rate of complications and pneumothorax SVP. Objective To compare efficacy safety compared with CIED a meta-analysis. Methods We systematically searched Medline, Embase Cochrane electronic databases up September 5th, 2022, studies that evaluated reporting at least one clinical outcome interest. The primary was acute procedural success. secondary outcomes were pneumothorax, failure, pocket hematoma/bleeding, device infection, total procedure time, venous access time fluoroscopy time. effect size estimated using random-effect model Risk Ratio (RR) relative 95% Confidence Interval (CI). Results A 8 included enrolling 1926 patients 3532 leads average age 72.3±14.8 years. showed significant increase in success (95.7% vs 76.1%; RR: 1.24; CI: 1.09-1.40; p=0.001), (Figure 1). Total (Mean Difference [MD]: -8.25 min; 95%CI: -10.23- -6.27; p<0.0001) Venous (MD: -6.24 -7.01- -5.47; significantly shorter CVC. No differences found between (RR: 0.72; 0.13 - 4.0; p=0.71), failure 0.58; 0.23-1.48; p=0.26), hematoma/bleeding 0.15- 2.23; p=0.43), infection 0.95; 0.14- 6.60; p=0.96) -0.24 -0.75- 0.28; p=0.36). Conclusion Our meta-analysis proved improves reduces Figure 1 – Forest plots comparing Acute Procedural Success Axillary Vein Puncture Versus Cephalic Cutdown.