{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T13:46:48Z","timestamp":1780667208690,"version":"3.54.1"},"reference-count":15,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T00:00:00Z","timestamp":1687910400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Cephalic vein cutdown (CVC) and axillary vein puncture (AVP) are both recommended for transvenous implantation of leads for cardiac implantable electronic devices (CIEDs). Nonetheless, it is still debated which of the two techniques has a better safety and efficacy profile.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We systematically searched Medline, Embase, and Cochrane electronic databases up to September 5, 2022, for studies that evaluated the efficacy and safety of AVP and CVC reporting at least one clinical outcome of interest. The primary endpoints were acute procedural success and overall complications. The effect size was estimated using a random\u2010effect model as risk ratio (RR) and relative 95% confidence interval (CI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, seven studies were included, which enrolled 1771 and 3067 transvenous leads (65.6% [<jats:italic>n<\/jats:italic>\u00a0=\u00a01162] males, average age 73.4\u00a0\u00b1\u00a014.3 years). Compared to CVC, AVP showed a significant increase in the primary endpoint (95.7 % vs. 76.1 %; RR: 1.24; 95% CI: 1.09\u20131.40; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.001) (Figure 1). Total procedural time (mean difference [MD]: \u22128.25\u00a0min; 95% CI: \u221210.23 to \u22126.27; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.0001; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00%) and venous access time (MD: \u22126.24\u00a0min; 95% CI: \u22127.01 to \u22125.47; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.0001; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00%) were significantly shorter with AVP compared to CVC. No differences were found between AVP and CVC for incidence overall complications (RR: 0.56; 95% CI: 0.28\u20131.10; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.09), pneumothorax (RR: 0.72; 95% CI: 0.13\u22124.0; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.71), lead failure (RR: 0.58; 95% CI: 0.23\u20131.48; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.26), pocket hematoma\/bleeding (RR: 0.58; 95% CI: 0.15\u20132.23; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.43), device infection (RR: 0.95; 95% CI: 0.14\u20136.60; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.96) and fluoroscopy time (MD: \u22120.24\u00a0min; 95% CI: \u22120.75 to 0.28; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.36).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our meta\u2010analysis suggests that AVP may improve procedural success and reduce total procedural time and venous access time compared to CVC.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.14728","type":"journal-article","created":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T13:19:35Z","timestamp":1687958375000},"page":"942-947","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Axillary vein puncture versus cephalic vein cutdown for cardiac implantable electronic device implantation: A meta\u2010analysis"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1120-0492","authenticated-orcid":false,"given":"Giampaolo","family":"Vetta","sequence":"first","affiliation":[{"name":"Cardiology Unit Department of Clinical and Experimental Medicine University of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Magnocavallo","sequence":"additional","affiliation":[{"name":"Cardiology Division Arrhythmology Unit S. Giovanni Calibita Hospital Isola Tiberina  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Parlavecchio","sequence":"additional","affiliation":[{"name":"Cardiology Unit Department of Clinical and Experimental Medicine University of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodolfo","family":"Caminiti","sequence":"additional","affiliation":[{"name":"Cardiology Unit Department of Clinical and Experimental Medicine University of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Polselli","sequence":"additional","affiliation":[{"name":"Cardiology Division Arrhythmology Unit S. Giovanni Calibita Hospital Isola Tiberina  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Sorgente","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre Postgraduate Program in Cardiac Electrophysiology and Pacing Universitair Ziekenhuis Brussel\u2010Vrije Universiteit Brussel European Reference Networks Guard\u2010Heart  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo Maria","family":"Cauti","sequence":"additional","affiliation":[{"name":"Cardiology Division Arrhythmology Unit S. Giovanni Calibita Hospital Isola Tiberina  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Crea","sequence":"additional","affiliation":[{"name":"Cardiology Unit Department of Clinical and Experimental Medicine University of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Pannone","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre Postgraduate Program in Cardiac Electrophysiology and Pacing Universitair Ziekenhuis Brussel\u2010Vrije Universiteit Brussel European Reference Networks Guard\u2010Heart  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Marcon","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre Postgraduate Program in Cardiac Electrophysiology and Pacing Universitair Ziekenhuis Brussel\u2010Vrije Universiteit Brussel European Reference Networks Guard\u2010Heart  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando Lo","family":"Savio","sequence":"additional","affiliation":[{"name":"Cardiology Unit Department of Clinical and Experimental Medicine University of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Pistelli","sequence":"additional","affiliation":[{"name":"Cardiology Unit Department of Clinical and Experimental Medicine University of Messina  Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Vetta","sequence":"additional","affiliation":[{"name":"Saint Camillus International University of Health Sciences  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian\u2010Battista","family":"Chierchia","sequence":"additional","affiliation":[{"name":"Heart Rhythm Management Centre Postgraduate Program in Cardiac Electrophysiology and Pacing Universitair Ziekenhuis Brussel\u2010Vrije Universiteit Brussel European Reference Networks Guard\u2010Heart  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Rossi","sequence":"additional","affiliation":[{"name":"Cardiology Division Arrhythmology Unit S. 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Della","family":"Rocca","sequence":"additional","affiliation":[{"name":"Texas Cardiac Arrhythmia Institute St. David's Medical Center  Austin Texas USA"},{"name":"Heart Rhythm Management Centre Postgraduate Program in Cardiac Electrophysiology and Pacing Universitair Ziekenhuis Brussel\u2010Vrije Universiteit Brussel European Reference Networks Guard\u2010Heart  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540\u20108159.2011.03150.x"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0003\u20104975(10)62705\u20101"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt\u20102014\u2010000177"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab364"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eut345"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euw363"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euw147"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2700"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14060"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2020.04.030"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14939"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euv066"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540\u20108159.2006.00451.x"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euaa367"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2020.01.006"}],"container-title":["Pacing and Clinical Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pace.14728","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T05:56:34Z","timestamp":1691733394000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pace.14728"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,28]]},"references-count":15,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1111\/pace.14728"],"URL":"https:\/\/doi.org\/10.1111\/pace.14728","archive":["Portico"],"relation":{},"ISSN":["0147-8389","1540-8159"],"issn-type":[{"value":"0147-8389","type":"print"},{"value":"1540-8159","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,28]]},"assertion":[{"value":"2022-12-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}