[Sub-coraco-clavicular approach of the axillary vein]

This prospective study aimed to assess the value of the infraclavicular route for axillary vein catheterization in intensive care patients. Forty-six patients, 26 to 90 years old, were assigned to one of two groups according to their body mass index: obese (W/H2 < 30) and non obese (W/H2 < 30). The three operators were not previously trained for this particular technique, but were familiar with others. There were 55 attempts. Overall success rate was 47%; 8% in obese and 58% in non obese patients respectively. Perceiving axillary artery beats beneath the coracoid process increased significantly the success rate in non obese patients (94%; p < 0.01). There was one major complication (pneumothorax), due to a non respect of the technique. In conclusion, this technique requires a previous training period, and is not to be recommended in the obese. However, it is a convenient technique for non obese patients, in whom axillary artery beats can be detected.