Comparative evaluation of subclavian vein catheterization using supraclavicular versus infraclavicular approach

Supraclavicular approach (SC) is less popular route of subclavian vein catheterization than infraclavicular approach (IC). The aim of the study was to compare the advantages and disadvantages of subclavian vein catheterization by either approach and also record the incidence of complications, if any.

In the study, 50 patients enrolled were randomly divided into two groups of 25 patients each. In Grp. SC, Subclavian vein catheterization was performed using SC approach and in Grp. IC catheterization was performed using IC approach. Access time, success rate of cannulation, number of attempts to cannulate vein, ease of guidewire and catheter insertion and length of catheter inserted and any associated complications were recorded.

SC approach offers distinct advantage that catheter is always guided downwards with greater ease in contrast to IC approach where catheter may be guided upwards. Secondly, it can be used intraoperatively and on mechanically ventilated patients duo to it's cephalad access. Sometimes when IC approach fails, anesthetists awareness of this alternate approach helps in successful placement of central venous catheter.