SCAI Position Statement on Best Practices for Percutaneous Axillary Arterial Access and Training
Arnold H. Seto, Jerry D. Estep, Rajiv Tayal, Shirling Tsai, John C. Messenger, M. Chadi Alraies, Darren B. Schneider, Andrew Klein, Yazan Duwayri, James M. McCabe, Suzanne J. Baron, Venu Vadlamudi, Timothy D. Smith, David A. Baran
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.