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Although useful for overcoming hostile iliofemoral anatomy and providing prolonged support and patient mobilization in case of MCS, the axillary\/subclavian territory poses distinct technical and anatomical challenges that demand meticulous pre\u2010procedural imaging, patient selection, accurate puncture under ultrasound and angiographic guidance, preservation of bailout access, and familiarity with suture\u2010based and balloon\u2010assisted closure strategies. This review provides a contemporary practical framework for percutaneous transaxillary access, summarizing the available clinical evidence, technical aspects of puncture and closure, complication management, and procedural tips to improve safety and reproducibility.<\/jats:p>","DOI":"10.1002\/ccd.70759","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T13:42:27Z","timestamp":1784641347000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Percutaneous Transaxillary Access for Large\u2010Bore Cardiovascular Interventions: Evidence, Technique, and Complication Management"],"prefix":"10.1002","author":[{"given":"Gioel Gabrio","family":"Secco","sequence":"first","affiliation":[{"name":"Interventional Cardiology Unit, AOU SS Antonio e Biagio e Cesare Arrigo Alessandria Italy"},{"name":"Department of Translational Medicine University of Eastern Piedmont Novara 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