229 results match your criteria Central Venous Access Subclavian Vein Subclavian Approach


Hydrolocation Assisted Subclavian Venous Catheterization.

Korean J Anesthesiol 2022 Jun 28. Epub 2022 Jun 28.

Clinical Assistant Professor, Discipline of Anesthesia, Memorial University of Newfoundland.

Background: Of the three common central access sites, subclavian vein catheterization has the lowest risk of infection but the highest risk of pneumothorax. The main disadvantage of the short-axis ultrasound guided approach is difficult needle-tip visualization. We describe use of the hydrolocation technique to improve needle-tip localization. Read More

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Different venous approaches for implantation of cardiac electronic devices. A network meta-analysis.

Pacing Clin Electrophysiol 2022 Jun 18;45(6):717-725. Epub 2022 May 18.

Cardiology Department, Athens General Hospital "G. Gennimatas", Athens, Greece.

Objectives: Many of the complications arising from cardiac device implantation are associated to the venous access used for lead placement. Previous analyses reported that cephalic vein cutdown (CVC) is safer but less effective than subclavian vein puncture (SVP). However, comparisons between these techniques and axillary vein puncture (AVP) - guided either by ultrasound or fluoroscopy - are lacking. Read More

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A Comparison of Central Venous Access to the Internal Jugular Vein and Two Standard Approaches to the Subclavian Vein: A Study of Cross-Sectional Areas Using Computed Tomography Scans.

Cureus 2022 Apr 4;14(4):e23823. Epub 2022 Apr 4.

Anesthesiology, University of Florida, Gainesville, USA.

Introduction The supraclavicular approach to the subclavian vein has been cited as having many advantages to the infraclavicular approach, including a larger short-axis cross-sectional area, a greater margin of safety, and fewer complications. Methods To examine whether a larger short-axis cross-sectional area of the subclavian vein at the supraclavicular fossa is a potential explanation for the reduction in attempts with the supraclavicular approach seen in a previous study, we examined computed tomography scans from 50 patients (24 M, 26 F). The short-axis cross-sectional areas of the subclavian vein at the mid-clavicular line, the subclavian vein in the supraclavicular fossa, and the internal jugular vein at the level of the thyroid cartilage were calculated. Read More

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Success Rate and Complications of the Supraclavicular Approach for Central Venous Access: A Systematic Review.

Cureus 2022 Apr 3;14(4):e23781. Epub 2022 Apr 3.

Internal Medicine, Ibn e Sina Hospital, Kabul, AFG.

Central venous catheterization plays a key role in patients that require immediate resuscitation, long-term fluid management, and invasive monitoring. The supraclavicular (SC) and infraclavicular (IC) approaches are utilized for central venous catheterization and both have their benefits and limitations. In this systematic review, we aim to explore the success rate and various complications of the SC technique. Read More

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Advancing Point-of-Care Ultrasound Training in Medical Schools: Ultrasound-Guided Subclavian Vein Access Training Using Formalin-Embalmed Cadavers.

Crit Care Explor 2022 Apr 25;4(4):e0680. Epub 2022 Apr 25.

Rocky Vista University College of Osteopathic Medicine - Southern Utah, Ivins, UT.

This brief report examines the feasibility of using formalin-embalmed cadavers in training medical students to use ultrasound guidance to access the subclavian. This novel educational approach is discussed in the context of the ongoing integration of point-of-care ultrasound training into medical education. Additionally, this report explores how cadavers can provide practical, effective, and hands-on skills training opportunities for medical students to learn to perform common clinical procedures under ultrasound guidance. Read More

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Unguided temporary pacing via jugular/subclavian vein in an emergency department of a high-volume tertiary care hospital of India: its safety, efficacy, and practicability.

Egypt Heart J 2022 Apr 25;74(1):33. Epub 2022 Apr 25.

Department of Cardiology, LPS Institute of Cardiology, GSVM, GT Road, Swaroop Nagar, Kanpur, UP, 208002, India.

Background: Temporary pacing is usually performed by cardiologists under fluoroscopic, echocardiographic, or ECG guidance. However, in the developing world, there are inadequate number of cardiologists, and C-arm, catheterization laboratories, or echocardiography are not available at primary or secondary healthcare facilities. In addition, in emergencies option of fluoroscopy and echocardiography is limited. Read More

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Right subclavian artery to right atrium bypass using Polytetrafluoroethylene (PTFE) graft in hemodialysis patient with central venous occlusion: Case report.

Ann Med Surg (Lond) 2022 Apr 3;76:103438. Epub 2022 Mar 3.

Department of Vascular Surgery, Mohammed VI University Hospital of Oujda, Mohammed First University of Oujda, Morocco.

Introduction: Central venous Occlusion (CVO) is a serious complication that occurs mainly in patients with long term central venous catheters for dialysis. It remains a challenge in vascular surgery.

Case Presentation: We report a case of a patient with end-stage kidney disease (ESKD), who was admitted for chronic occlusion of the superior and inferior vena cava and underwent a right subclavian artery to right atrium (RA) bypass using polytetrafuloroetylene (PTFE) graft. Read More

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Safety of Insertion of Percutaneous Totally Implantable Central Venous Access Devices by Surgical Residents.

In Vivo 2022 Mar-Apr;36(2):985-993

Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan.

Background/aim: To compare the outcomes of totally implantable central venous access device (TIVAD) insertions by surgical residents (SRs) with those by experienced surgeons (ESs) and establish the safety of percutaneous TIVAD insertion by SRs.

Patients And Methods: A total of 700 insertions were successfully performed between January 2015 and December 2019 in our Department. The puncture site conversion and complication rates were compared, and risk factors related to complications were analysed. Read More

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Central Venous Catheter Tip Malposition After Internal Jugular Vein Cannulation in Pediatric Patients With Congenital Heart Disease.

J Cardiothorac Vasc Anesth 2022 Aug 25;36(8 Pt A):2483-2487. Epub 2022 Jan 25.

Department of Studies and Research, Oman Medical Specialty Board, Muscat, Oman.

Objectives: The primary objective of the study was to identify the incidence of catheter tip malposition as determined by postoperative radiography after central venous cannulation by right and left internal jugular venous routes in pediatric cardiac surgical patients. The secondary objective was to determine the relative risk of malposition between the 2 approaches into specific major thoracic veins other than the right superior vena cava.

Design: A prospective observational study. Read More

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A Training Program for Real-Time Ultrasound-Guided Catheterization of the Subclavian Vein.

J Med Educ Curric Dev 2021 Jan-Dec;8:23821205211025849. Epub 2021 Jun 30.

Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA.

Purpose: To develop and implement a comprehensive program to train providers to place subclavian central venous catheters (CVCs) using real-time ultrasound guidance.

Study Design: Simulation-based prospective study at an academic medical center. Of 228 anesthesia providers and intensivists eligible to participate, 106 participants voluntarily enrolled. Read More

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Supraclavicular versus infraclavicular approach for ultrasound-guided right subclavian venous catheterisation: a randomised controlled non-inferiority trial.

Anaesthesia 2022 01 6;77(1):59-65. Epub 2021 Jul 6.

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.

Infraclavicular and supraclavicular approaches are used for subclavian venous catheterisation. We hypothesised that the supraclavicular approach is non-inferior to the infraclavicular approach in terms of safety during ultrasound-guided right subclavian venous catheterisation. We randomly allocated 401 neurosurgical patients undergoing ultrasound-guided right subclavian venous catheterisation into supraclavicular (n = 200) and infraclavicular (n = 201) groups. Read More

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January 2022

Inadvertent Placement of Tunneled Hemodialysis Catheter in Persistent Left Superior Vena Cava.

Saudi J Kidney Dis Transpl 2021 Jan-Feb;32(1):232-235

Shree Imaging Center, Thane, Maharashtra, India.

Persistent left superior vena cava (PLSVC) is the most common congenital intrathoracic venous anomaly with significant clinical relevance. In the vast majority of cases, it is asymptomatic and diagnosed after noticing an abnormal course of central venous access device on a routine post-procedure roentgenogram. It may also be accidentally discovered after facing difficulty in accessing the right side of the heart from a left internal jugular vein or left subclavian vein approach, a common site of access while placing cardiac pacemaker and Swan-Ganz catheter, or after a complication associated with hemodialysis (HD) catheter insertion. Read More

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December 2021

Forty years after the first totally implantable venous access device (TIVAD) implant: the pure surgical cut-down technique only avoids immediate complications that can be fatal.

Langenbecks Arch Surg 2021 Sep 9;406(6):1739-1749. Epub 2021 Jun 9.

Department of Surgical Sciences and Advanced Technologies "G.F. Ingrassia," Cannizzaro Hospital, General Surgery, University of Catania, Via Messina 829, 95126, Catania, Italy.

Aim: Even though TIVADs have been implanted for a long time, immediate complications are still occurring. The aim of this work was to review different techniques of placing TIVAD implants to evaluate the aetiology of immediate complications.

Methods: A systematic literature review was performed using the PubMed, Cochrane and Google Scholar databases in accordance with the PRISMA guidelines. Read More

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September 2021

Cannulation of the subclavian vein using real-time ultrasound guidance.

J Intensive Care Soc 2020 Nov 23;21(4):349-354. Epub 2020 Jan 23.

Department of Intensive Care, University College Hospital, London, UK.

Cannulation of the subclavian vein has many advantages when compared to other anatomical sites for central venous access. Difficulty in its ultrasonic visualisation, and the perceived consequent 'higher' complication rate, mean that this approach has fallen out of favour. This barrier, however, may now have disappeared. Read More

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November 2020

Technical factors and outcomes in pediatric central venous port placement.

J Pediatr Surg 2022 Mar 26;57(3):450-453. Epub 2021 Feb 26.

Northwestern University, Feinberg School of Medicine, Chicago, IL, United States; Department of Surgery, Ann & Robert H Lurie Children's Hospital of Chicago, 225 E Chicago Ave, Box 63, Chicago, IL 60611, United States. Electronic address:

Purpose While central venous port placement is common, there remains variation in placement technique and rates of technical complications. The aim of this study was to assess variability in techniques and identify predictors of complications for children undergoing port placement. Methods We retrospectively reviewed all 331 patients who underwent venous port placement at a single tertiary children's hospital from May 2018 to June 2020. Read More

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Thoracic outlet decompression for subclavian venous stenosis after ipsilateral hemodialysis access creation.

J Vasc Surg Venous Lymphat Disord 2021 11 3;9(6):1473-1478. Epub 2021 Mar 3.

Department of Vascular Surgery, Sydell and Arnold Miller Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio. Electronic address:

Objective: Central venous stenosis is one of the most challenging complications in patients requiring hemodialysis. Venous thoracic outlet syndrome is an underappreciated cause of central venous stenosis in patients requiring dialysis that can result in failed percutaneous intervention and loss of a functioning dialysis access. Limited data exist about the safety and outcomes of first rib resection in patients requiring hemodialysis, and the results have been confounded by the various surgical approaches used. Read More

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November 2021

The value of real-time ultrasound-guidance for definite placement of a right supraclavicular subclavian central venous catheter.

J Vasc Access 2022 May 1;23(3):474-476. Epub 2021 Mar 1.

Department of Anesthesiology and Operative Intensive Care Medicine, University Hospital of Bonn, Bonn, Germany.

Central venous catheters (CVC) are widely used in critically ill patients and in those undergoing major surgery. Significant adverse events, such as pneumothorax and hemothorax, can be caused by needle insertion during CVC insertion. CVC misplacement is less often described, yet equally important, as it can lead to deleterious complications. Read More

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Ultrasound guided percutaneous cephalic venipuncture for implantation of cardiac implantable electronic devices.

J Vasc Access 2022 May 24;23(3):416-421. Epub 2021 Feb 24.

Department of Cardiology, Health Sciences University, Derince Training and Research Hospital, Kocaeli, Turkey.

Background: Preoperative ultrasound (US) for cephalic cut-down is related to shorter procedure time and higher success rate. This study aimed to assess efficiency of US-guided percutaneous cephalic vein (CV) puncture for placement of cardiac implantable electronic devices (CIEDs).

Methods: Patients undergoing a procedure including both US-guided pectoral nerve block (PECS) and percutaneous CV puncture were retrospectively investigated. Read More

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Totally implantable venous access devices: The supraclavicular percutaneous approach and early complications.

J Cancer Res Ther 2020 ;16(7):1575-1581

Department of Interventional Radiology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Provinece, China.

Background: The background of this study was to explore the success rate and early complications concerning the implantation of totally implantable venous access devices (TIVADs) by percutaneous venipuncture and management strategies for early complications.

Materials And Methods: This was a retrospective study of 1923 patients who received TIVAD implantation by percutaneous venipuncture (mostly via the supraclavicular route). The percutaneous access sites were internal jugular vein (810 patients; right/left: 158/652) or proximal right internal jugular vein, brachiocephalic vein, and proximal subclavian vein (1113 patients). Read More

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October 2021

Totally implantable venous access port insertion via open Seldinger approach of the internal jugular vein-a retrospective risk stratification of 500 consecutive patients.

Langenbecks Arch Surg 2021 May 7;406(3):903-910. Epub 2021 Feb 7.

Department of General, Visceral and Transplant Surgery, University Hospital Münster, Waldeyerstrasse 1, 48149, Münster, Germany.

Purpose: Modern oncological treatment algorithms require a central venous device in form of a totally implantable venous access port (TIVAP). While most commonly used techniques are surgical cutdown of the cephalic vein or percutaneous puncture of the subclavian vein, there are a relevant number of patients in which an additional strategy is needed. The aim of the current study is to present a surgical technique for TIVAP implantation via an open Seldinger approach of the internal jugular vein and to characterize risk factors, associated with primary failure as well as short- (< 30 days) and long-term (> 30 days) complications. Read More

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Meta-analysis of primary open versus closed cannulation strategy for totally implantable venous access port implantation.

Langenbecks Arch Surg 2021 May 9;406(3):587-596. Epub 2021 Jan 9.

Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany.

Background: There is still no reference standard for the implantation of totally implantable venous access ports (TIVAPs). A recently published multicentre randomised controlled trial (RCT) revealed a significantly greater risk of pneumothorax after closed cannulation than after an open strategy. The aim of this meta-analysis was to provide an update of the available evidence for the safety and effectiveness of primary open versus closed cannulation strategy. Read More

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Optimal insertion depth of subclavian vein catheterization via the right supraclavicular approach in children.

Paediatr Anaesth 2021 03 27;31(3):346-351. Epub 2021 Jan 27.

Department of Anesthesiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China.

Background: Methods to determine the optimal insertion depth of ultrasound-guided supraclavicular approach to the subclavian vein (SCV) catheterization, alternatively used for central venous access, are debatable in children.

Aim: We investigated the applicability and reliability of the modified formula for determining the depth of SCV catheterization using an ultrasound-guided supraclavicular approach in children.

Methods: This prospective observational study included 36 children (age <6 years; weight ≥5 kg) scheduled to undergo congenital heart disease surgery. Read More

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Application of transesophageal echocardiography for localization in totally implantable venous access port implantation through subclavian approach in children.

Clin Cardiol 2021 Jan 25;44(1):129-135. Epub 2020 Nov 25.

Department of Surgical Oncology, Chongqing Medical University Affiliated Children's Hospital, Chongqing, China.

A totally implantable venous access port (TIVAP) is important in children who need intravenous infusion for a long time. A number of studies have shown methods for locating the tip of the TIVAP catheter. To explore whether transesophageal echocardiography (TEE) can be used to accurately locate the TIVAP catheter tip through a subclavian approach and to improve the rate of correct TIVAP catheter placement and reduce complications of TIVAP placement. Read More

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January 2021

Supraclavicular versus infraclavicular approach in inserting totally implantable central venous access for cancer therapy: A comparative retrospective study.

PLoS One 2020 24;15(11):e0242727. Epub 2020 Nov 24.

Surgical Oncology Department, National Institute of Oncology, Mohammed V University Medical School, Rabat, Morocco.

Introduction: The insertion of an implantable central venous access is performed according to a variety of approaches which allow the access to the subclavian vein, yet the supraclavicular technique has been underused and never compared to the other methods. The aim of this study was to testify on the efficacy and safety of the subclavian puncture without ultrasound guidance « Yoffa » in comparison with the classical infraclavicular approach (ICA).

Material And Methods: This is a retrospective study with prospective data collection on patients followed at the national oncology institute for cancer, in the period extending from May 1st 2017 to August 31st 2017. Read More

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January 2021

Pleural effusion with arm, breast, and face edema as a complication of subclavian vein catheterization and arteriovenous fistula in a patient after renal transplantation: A therapeutic approach.

J Vasc Access 2021 Nov 26;22(6):1017-1020. Epub 2020 Sep 26.

Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wrocław, Poland.

A 52-year-old woman after renal transplantation developed unilateral pleural effusion as well as a massive edema of the upper limb, breast, and face as a complication of the subclavian vein catheterization and arteriovenous fistula for hemodialysis. We revealed that impaired venous drainage due to extensive vein occlusion after temporary catheter insertion, together with high venous flow from the arteriovenous fistula, were the explanation. Because of moderately impaired renal graft function and limited availability of vascular access in the patient, fistula ligation as a therapeutic method described in literature, was not an option in our case. Read More

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November 2021

Expert consensus-based clinical practice guidelines management of intravascular catheters in the intensive care unit.

Ann Intensive Care 2020 Sep 7;10(1):118. Epub 2020 Sep 7.

Surgical and Medical Intensive Care Unit Hôpital, Raymond Poincaré, 9230, Garches, France.

The French Society of Intensive Care Medicine (SRLF), jointly with the French-Speaking Group of Paediatric Emergency Rooms and Intensive Care Units (GFRUP) and the French-Speaking Association of Paediatric Surgical Intensivists (ADARPEF), worked out guidelines for the management of central venous catheters (CVC), arterial catheters and dialysis catheters in intensive care unit. For adult patients: Using GRADE methodology, 36 recommendations for an improved catheter management were produced by the 22 experts. Recommendations regarding catheter-related infections' prevention included the preferential use of subclavian central vein (GRADE 1), a one-step skin disinfection(GRADE 1) using 2% chlorhexidine (CHG)-alcohol (GRADE 1), and the implementation of a quality of care improvement program. Read More

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September 2020

Comparison of the proximal and distal approaches for axillary vein catheterization under ultrasound guidance (PANDA) in cardiac surgery patients susceptible to bleeding: a randomized controlled trial.

Ann Intensive Care 2020 Jul 8;10(1):90. Epub 2020 Jul 8.

Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China.

Background: The present study aimed at comparing the success rate and safety of proximal versus distal approach for ultrasound (US)-guided axillary vein catheterization (AVC) in cardiac surgery patients susceptible to bleeding.

Methods: In this single-center randomized controlled trial, cardiac surgery patients susceptible to bleeding and requiring AVC were randomized to either the proximal or distal approach group for US-guided AVC. Patients susceptible to bleeding were defined as those who received oral antiplatelet drugs or anticoagulants for at least 3 days. Read More

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Ultrasound-guided double central venous access for azygos vein via the ninth and tenth intercostal veins.

J Vasc Access 2021 Mar 30;22(2):304-309. Epub 2020 Jun 30.

Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.

Some patients with intestinal failure, who are dependent on total parenteral nutrition for long periods, suffer from a lack of suitable conventional venous access points, including axillary, external jugular, internal jugular, subclavian, saphenous, and the brachio-cephalic and femoral veins, due to their occlusion. Furthermore, extensive central venous stenosis and/or thrombosis of the superior and inferior vena cava may preclude further catheterization, so uncommon routes must be used, which can be challenging. In such patients, the azygos vein via the intercostal vein is a viable candidate. Read More

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Body mass index is related to unsuccessful puncture attempts and failure to axillary vein cannulation during ultrasound-guided cardiac electronic device implantation.

J Interv Card Electrophysiol 2021 Aug 23;61(2):253-259. Epub 2020 Jun 23.

Electrophysiology Unit, Cardiology Department, ESTAV Toscana Sud Est, Misericordia Hospital, Via Senese 161, 58100, Grosseto, Italy.

Purpose: Ultrasound (US)-guided axillary vein cannulation is effective and safe during cardiac implantable electronic devices (CIEDs). It is a reasonable alternative to other techniques in order to shorten procedural time and decrease perioperative complications. However, in this context, the short-axis (out-of-plane) visualization to guide the vein puncture is the most used technique. Read More

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Feasibility of the ultrasound-guided supraclavicular cannulation of the brachiocephalic vein in very small weight infants: A case series.

Paediatr Anaesth 2020 08 25;30(8):928-933. Epub 2020 Jun 25.

Department of Anesthesia, Klinikum Klagenfurt, Klagenfurt, Austria.

Background: The aim of this retrospective analysis was to evaluate the clinical feasibility of the supraclavicular ultrasound-guided cannulation of the brachiocephalic vein in infants weighing less than 1500 g.

Methods: The ultrasound probe was placed in the supraclavicular region so as to obtain the optimum sonographic long-axis view of the brachiocephalic vein. By using an in-plane approach the brachiocephalic vein was cannulated by using a 24-gauge intravenous cannula under real-time ultrasound guidance into the vein followed by the insertion of a 2-French single lumen catheter using the Seldinger technique. Read More

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