[Technical difficulties of puncture and the functional anatomy of the subclavian vein]

The difficulties occurring during puncture subclavian catheterization (PSC) are discussed. The results of 4559 PSC in 4007 patients are analysed. The results of ultrasonic examination (198 patients) and postmortem X-ray studies (34 cases) of the subclavian vein anatomy are presented. A great variability in the subclavian vein anatomy has been observed, this is associated with a likelihood of technical difficulties, failures and complications in standard PSC technique. An ultrasonic examination prior to PSC is recommended.