Guide-wire embolism during subclavian vein catheterization by Seldinger technique

2006 ◽  
Vol 10 (4) ◽  
pp. 257-259 ◽  
Author(s):  
H. Narendra ◽  
K. R. Baghavan
2020 ◽  
Vol 3 (2) ◽  
pp. 111-115
Author(s):  
Robin Khapung ◽  
Jeju Nath Pokharel ◽  
Kiran Kumar KC ◽  
Kripa Pradhan ◽  
Uma Gurung ◽  
...  

Introduction: Central vein catheterization can be introduced in subclavian vein (SCV), internal jugular vein or femoral vein for volume resuscitation and invasive monitoring technique. Due to anatomical advantage and lesser risk of infection subclavian vein is preferred. Either supraclavicular (SC) or infraclavicular (IC) approach could be used for subclavian vein catheterization. The aim of the study was to compare SC and IC approach in ease of catheterization of SCV and record the complications present if any. Methods and materials: This was a hospital based comparative, interventional study conducted from November 2016 to October 2017 in Operation Theater in Bir Hospital. In this study, 70 patients for elective surgical cases meeting the inclusion criteria were randomly enrolled. Then samples were equally divided by lottery into either supraclavicular or infraclavicular approach groups. The Access time, cannulation success rate, attempts made for successful cannulation of vein, easy insertion of catheter and guide wire, approximate inserted length of catheter and associated complications in both groups were recorded. Data was entered in statistical software SPSS 16. Chi-square test was used. P value < 0.05 was considered significant. Results: The mean access time in group SC for SCV catheterization was 2.12 ± 0.81 min compared to 2.83 ± 0.99 min in group IC (p-value= 0.002). The overall success rate in catheterization of the right SCV using SC approach (34 / 35) was better as compared with group IC (33 / 35) using IC approach. First successful attempt in the SC group was 74.28% as compared with 57.14% in the IC group. Conclusion: The SC approach of SCV catheterization can be considered alternative to IC approach in terms of landmark accessibility, success rate and rate of complications.


2021 ◽  
Vol 8 (3) ◽  
pp. 408-412
Author(s):  
Amit Bodkhe ◽  
Avanti Purohit ◽  
Chitra Pitale ◽  
Hemant Bhirud

The subclavian vein is the preferred site for central venous catheter insertion because of its several advantages. Infraclavicular is the commonly used approach while supraclavicular is less popular approach for catheterizing the subclavian vein. The aim of the study was to compare supraclavicular and infraclavicular approach of subclavian vein catheterization in terms of number of attempts, success rate, access time for catheterization and to record the complications associated with the procedure. In this study, 120 patients of inclusion criteria were placed either in group supraclavicular (SC) or group infraclavicular (IC) for subclavian vein catheterization using modified Seldinger technique under general or local anaesthesia.Chi square test was used to compare success rate and independent T test for access time of catheterization between two groups. First attempt success rate in group SC was 81.66% and in group IC was 66.66%. But overall success rate was 93.33% in group SC, whereas it was 90% in group IC. This was not statistically significant with p value of 0.5. Time taken for successful catheterization was 252.98 ± 76.27 seconds in group SC and 314.98 ± 121.28 seconds in group IC. This was statistically significant with p value of 0.001.Right brachiocephalic vein tear was the only complication in entire study which occurred in group IC. Subclavian vein catheterization via supraclavicular approach was a faster approach than infraclavicular, whereas both were comparable in terms of success rate.


2007 ◽  
Vol 11 (3) ◽  
pp. 149-150
Author(s):  
P. Jain ◽  
J.C. Muthusami ◽  
J.P. Raj* ◽  
P. Gaikwad ◽  
J. Rajinikanth ◽  
...  

Author(s):  
Dr. Sandeep Madaan ◽  
Dr. Lavlesh Mittal

INTRODUCTION: Deep knowledge of anatomy is an essential part of surgical practice. Students of medical sciences gain knowledge and theoretical data through actual visualization of anatomic structures of the cadavers also anatomic relations can be studied more efficiently by practicing on cadavers. As phrenic nerve may be damaged during subclavian vein catheterization the relationship between the phrenic nerve and the subclavian vein is of clinical interest. During the subclavian vein catheterization analogous variable relationships are helpful to explain and prevent damage to the phrenic nerve. MATERIAL AND METHODS: Dissection was started from the root of the neck. No surgical scars, gross anatomical and morphological abnormalities was noted on the cadaver. Measurements were taken during the anatomical dissections.  RESULTS: Of the 36 cadavers dissected in 34 (94.44%) cases phrenic nerve was found posterior to the subclavian vein and in 2(5.56%) cases found anterior to the subclavian vein of which one case was male and the other was female. In the male case in which phrenic nerve was passing anterior to the subclavian vein, it was adherent to the anterior wall of the subclavian vein and was nor piercing the vein wall. CONCLUSION: The cannulating needle may damage the phrenic nerve which is adherent to the subclavian vein. So, the puncture site should be more laterally at the outermost portion of the subclavian vein. Anatomical variants during invasive practical procedures should be always kept in mind. KEYWORDS: phrenic nerve, subclavian vein, phrenic nerve palsy, catheterization.


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