Liccardo M, et al. - This study reports comparative efficacies of ultrasound-guided axillary vs subclavian approaches for pacemaker and defibrillator lead implantation. Compared with the subclavian approach, ultrasound-guided axillary method, as a first attempt, afforded similar high-success rate and well performed when the first attempt in subclavian group failed. In addition, as an alternative to the conventional subclavian method, axillary access can be considered a safe and effective option for device implantation.