Supraclavicular Catheterization of the Superior Vena Cava

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Abstract
In seeking to develop a simple and safe technique of central vein catheterization, a supraclavicular route to the superior vena cava was chosen. Advancing from a point above the medial portion of the clavicle, the needle punctures the wall at the confluence of the subclavian and internal jugular veins, and a siliconized catheter is introduced straight into the superior vena cava. The technique is described in detail.The results of 600 catheterizations are reported. Unsuccessful attempts at cannulation were recorded in 6.3%, malposition of the tip of the catheter in 1.7%, pneumothorax in 0.3% and other complications in altogether 3.3% of the cases. Attention is drawn to the potential dangers inherent in cannulation of major central veins. The supraclavicular route described seems to provide a straightforward, reproducible approach to the superior vena cava, and it seems to have a low incidence of technical failures and early and late complications.