Simplifying subclavian vein cannulation using innovative landmarks: a radiologic, anatomic, and clinical study

Area of Science:

• Vascular Access
• Medical Device Technology
• Anatomy and Physiology

Background:

• Subclavian vein (SV) cannulation is a critical procedure in intensive care.
• Identifying optimal and reliable landmarks for SV cannulation remains a challenge.
• Existing methods may have limitations in terms of success rate and ease of use for beginners.

Purpose of the Study:

• To investigate novel and optimal anatomical landmarks for subclavian vein cannulation.
• To develop and validate a new approach for SV cannulation.
• To compare the efficacy of the new approach against traditional methods.

Main Methods:

• Phase 1: Anatomical measurements and radiological evaluation of SV course in ICU patients.
• Phase 2: Comparison and adjustment of data to propose innovative landmarks and a new cannulation approach.
• Phase 3: Prospective, randomized, controlled study comparing the new method with the traditional one.

Main Results:

• Identified Points A and B as novel, reliable landmarks for SV cannulation, located close to Point D.
• Beginners demonstrated a significantly higher success rate (86.9% vs. 70.2%) using the new method.
• The new approach significantly reduced cannulation time (5.9 min vs. 10.4 min) compared to the traditional method.

Conclusions:

• Points A and B serve as effective innovative landmarks for identifying the subclavian vein puncture site.
• The novel approach using these landmarks significantly enhances success rates and decreases operation time for beginners.
• This research offers a more efficient and safer method for subclavian vein cannulation.