Ultrasound-guided infraclavicular axillary vein cannulation for central venous access

A Sharma, A R Bodenham, A Mallick
British Journal of Anaesthesia 2004, 93 (2): 188-92

BACKGROUND: Infraclavicular axillary vein cannulation is not commonly used for central venous access because identifying the surface landmarks is difficult. Ultrasound guided axillary vein puncture has not been well described. We assessed ultrasound imaging to guide catheterization of the infraclavicular axillary vein.

METHODS: In 200 consecutive patients we attempted to catheterize the axillary vein using ultrasound imaging. After successful venepuncture, a tunnelled Hickman line was inserted for long-term central venous access. Surface landmarks of the skin puncture site were measured below the clavicle. We measured the depth of the vein from the skin, the length of the guidewire from skin to carina and the final length of catheter that was inserted.

RESULTS: The axillary vein was successfully punctured with the help of ultrasound imaging with first needle pass in 76% of patients. The axillary vein was catheterized successfully in 96% of the cases. Guidewire malposition was detected and corrected by fluoroscopy in 15% of cases. Complications included axillary artery puncture in three (1.5%) and transient neuralgia in two (1%) cases.

CONCLUSION: Ultrasound-guided catheterization of the infraclavicular axillary vein is a useful alternative technique for central venous cannulation with few complications.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"