SCAI Position Statement on Best Practices for Percutaneous Axillary Arterial Access and Training

J Soc Cardiovasc Angiogr Interv. 2022 Apr 19;1(3):100041. doi: 10.1016/j.jscai.2022.100041. eCollection 2022 May-Jun.

Abstract

Axillary artery access has become increasingly widespread as an alternative to the femoral route for large-bore transcatheter aortic valve replacement (TAVR), endovascular aortic repair (EVAR), and mechanical circulatory support (MCS) procedures. Advantages of percutaneous access include avoidance of a surgical incision, general anesthesia, and conduit graft infection. This statement aims to review the anatomic considerations and risks for percutaneous axillary artery access, suggest best practices for access techniques, hemostasis/closure strategies, and complication management, and recommend options for training and privileging.