Top Tweets for #CephalicFirst
@EPWoodsShop @jeffrey_vinocur @StevenZweibel Me reading the comments and waiting for the annual #CephalicFirst versus #UltrasoundAxillaryFirst battle to start @narrowQRS @rdschaller
Elegant cephalic vein implant with graduating fellow @ChrisCheungMD.
Yep @narrowQRS, I still tie the sleeve (for single lead implants) into the venotomy the way you showed me my first day of fellowship #CephalicFirst #EPeeps
@rdschaller @SchakrabartiEP @jeffrey_vinocur @GPapiashvili @MDTolgaAksu @narrowQRS @psharmadoc @hhuang123 @prof_serkan_cay @gauravaupadhyay @PennEPFellows Extreme caudal view (50 degrees) for Axillary approach to puncture outside Rib Cage.
It is a game changer. Shallow Angle at entry point from pocket performed at deltopectoral groove.
Left panel: caudal view
Right panel: AP view
It worths a try.
#axillaryfirst
#cephalicfirst
@DrSuzyFeigofsky @JJcolemanMD I have used that also; with the 11 blade i think I can be more precise and I also use glide wire with its introducer. #cephalicfirst
#cephalicfirst #axillaryfirst Pacemaker leads faliure (2013 subclavian access) due to atypical crush syndrome on second rib
After-hours on-call pacemaker, am usually #cephalicfirst but nice to add #ultrasoundaxillary to the toolbox - will try the #SalcedoTwist next time! @DH_Lau @PrashSanders @50wattdoc @Kadhimad @mehrdademami @Dr_VarunMalik @Rajiv_EP #EPeeps #POCUS
And now the onslaught of #CephalicFirst chirping may begin 😉
@DrRoderickTung @EPWoodsShop @AxisDeviation @Firaszahwe @ALFIEEP1 @DoctorPhillEP @CarinaHardy4 @EJSMD @slatercharles1 @JDMossMD @B_Naz_MD @TinaBaykaner @narrowQRS @rdschaller @netta_doc @Dr_Santangeli @gautamsand
@narrowQRS @CGrebmer @SchakrabartiEP @naderjo @rdschaller @Hapa_EP @seth_j_worley @VKutyifa I used to use an 18 gauge + Terumo in Canada. In Argentina is more expensive so I had to reformat my technique.
But, 18 gauge + Terumo is the best way to go.
Avoid any puncture. Keep it simple
#cephalicfirst
@TinaBaykaner No, not w/ #UltrasoundAxillaryFirst technique. Haven’t had one in 6 yrs (knocking on some serious wood right now), but I tell my patients it’s ‘<0.5%’ just to give a number 🤷🏻♂️Curious what other #EPeeps quote? #CephalicFirst experts must also quote as low? @narrowQRS @rdschaller
@rdschaller @GSMedicine @narrowQRS @XCosteas @Dr_Santangeli Agree in general, except that this discussion was prompted by the suggestion that cephalic may actually have a downside relative to axillary. #cephalicfirst proponents remain appropriately skeptical. My hope is that others investigate - little literature on the topic.
Another win for #UltrasoundAxillaryFirst! Though I suspect most #cephalicfirst operators will argue over the 54.5% success rate, I feel the major take-home was taking 2 operators w/ no u/s ppm experience and achieving success (97.7%) and safety!
#EPeeps
https://t.co/euabNzlmFX
@narrowQRS @50wattdoc @slatercharles1 @rdschaller @TinaBaykaner @Dr_Santangeli @gautamsand @netta_doc If you have Micropunture and Ultrasound then I am not sure of benefit. I used to be #cephalicfirst. Now, I am 0% cephalic for last 4 years.
...and here we go down that rabbit hole again 😂 @slatercharles1
#UltrasoundAxillaryFirst vs. #cephalicfirst
#EPeeps @narrowQRS @rdschaller @TinaBaykaner @Dr_Santangeli @gautamsand @netta_doc
https://t.co/x2U56TILvm
https://t.co/BVNvD3GF1W
https://t.co/8tY9aYpFW8
Good job by @DJ_Lakkireddy @drrakeshg1 @mohitkturagam @KoerberScott But we, the ones who use cephalic, already knew this, didn’t we?😀😀
#Epeeps don’t get access like this. Coming in from steeply below, probably right through the costoclavicular ligament. V lead has rising impedance. Atrial lead will likely fail too. Access the axillary or cephalic veins lateral to 1st rib. #cephalicfirst #caudalclub
I put 3 leads in the cephalic the majority of the time, so need to be sorry. That’s direct visualization.#EPeeps #cephalicfirst
@LukerJakob @narrowQRS @Nishaki1 @martinkstiles @PrashSanders Nothing beats 1)direct visualization, 2)no-fluoro, 3)no-contrast, 3) 3-leads (sorry #cephalicfirst) 4)exact anatomic placement every time
#UltrasoundAxillaryFirst
#LongAxisUS
#SalcedoTwist
#POCUS
#EPeeps
@B_Naz_MD @drcasey_epdoc @doc_ccc @rdschaller @netta_doc @slatercharles1
@LukerJakob @narrowQRS @Nishaki1 @martinkstiles @PrashSanders Nothing beats 1)direct visualization, 2)no-fluoro, 3)no-contrast, 3) 3-leads (sorry #cephalicfirst) 4)exact anatomic placement every time
#UltrasoundAxillaryFirst
#LongAxisUS
#SalcedoTwist
#POCUS
#EPeeps
@B_Naz_MD @drcasey_epdoc @doc_ccc @rdschaller @netta_doc @slatercharles1
Which do you choose, #CephalicFirst or #AxillaryFirst ?
Fluoroscopy guided axillary vein access vs cephalic vein access in pacemaker & defibrillator implantation: Randomized clinical trial of efficacy & safety
See if the #EPeeps debate is settled ➨ https://t.co/Qs5eCMhS1p
This is why it is a bad idea to use central access. Lead encased in bone.
#EPeeps, the final round is here for the ongoing Mortal Kombat matchup btw #UltrasoundAxillaryFirst vs. #cephalicfirst! Video includes #SalcedoTwist shots and a ‘finishing’ #dontdisthehis maneuver. #SiliconValleyCardiology #cardiotwitter #POCUS #FOAM
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