Conclusion
This step-by-step guide describes an ultrasound guided vascular access
approach utilizing both short and long axis views for optimal
visualization of the axillary vasculature, expected surrounding
structures, and the approach of the needle tip as it tents and enters
the front wall of the axillary vein. The description and videos also
highlight the benefit of long axis ultrasound viewing angle in seeing
the tip of the access needle and aiding the operator to angle the needle
tip to catch the front wall of the vein, which augments the ease of a
twisting motion cutting into the vein. This will hopefully aid the
reader in adopting a technique that is efficient and provides an
extremely safe route of access for all CIED implantation.