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The malpositioned subclavian catheter

J E Gatti, J L Mullen

Surgery, Gynecology & Obstetrics

|July 1, 1981

Summary

This summary is machine-generated.

Inadvertent internal jugular vein cannulation during subclavian vein catheterization is common. A guide wire technique safely repositions catheters, avoiding removal and reinsertion for improved patient care.

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Area of Science:

Vascular Access Procedures
Interventional Cardiology
Medical Device Malpositioning

Background:

Infraclavicular subclavian vein catheterization is a common procedure.
Inadvertent cannulation of the internal jugular vein is a frequent complication.
Current management of malpositioned catheters may involve removal and reinsertion.

Purpose of the Study:

To investigate the safety and efficacy of a guide wire repositioning technique for malpositioned subclavian vein catheters.
To determine if fluoroscopy is necessary for successful catheter repositioning.
To establish a less invasive management strategy for internal jugular vein cannulation during subclavian catheterization.

Main Methods:

Review of 524 consecutive infraclavicular subclavian vein catheterizations.

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Application of a guide wire and anatomic maneuvers for catheter repositioning.

Evaluation of repositioning success with and without fluoroscopic guidance.

Main Results:

Inadvertent internal jugular vein cannulation occurred in a significant number of cases.
No difference in malpositioning rates between right and left subclavian approaches.
The guide wire repositioning technique was found to be safe and effective.
Successful repositioning into the superior vena cava was achieved without catheter removal.

Conclusions:

Malpositioned subclavian vein catheters due to internal jugular vein cannulation can be safely and effectively repositioned using a guide wire technique.
This method obviates the need for catheter removal and repeat percutaneous catheterization.
The technique offers a simple and safe solution for managing this common complication.