Comparison of Ultrasound-Guided Right Brachiocephalic and Right Subclavian Vein Cannulation in Adult Patients

J Ultrasound Med. 2019 Oct;38(10):2559-2564. doi: 10.1002/jum.14947. Epub 2019 Jan 28.

Abstract

Objectives: To compare ultrasound-guided right brachiocephalic vein (BCV) central venous catheter (CVC) placement to right subclavian vein (SCV) CVC insertion in terms of the puncture success rate and complications.

Methods: A retrospective review was performed for all adult patients who received an ultrasound-guided CVC via the right BCV or right SCV access route between January 2016 and March 2018. The puncture success rates and procedure-related complications were analyzed.

Results: Data were analyzed from 755 adult patients who underwent 915 CVC insertions. The overall success rate was higher in the BCV group compared to that in the SCV group (98.99% versus 96.87%; P = .019). The first-attempt success rate was higher in the BCV group compared to that in the SCV group (96.64% versus 89.34%; P < .001). Intraoperative complications were observed in 16 cases in the BCV group (2.68%) and in 12 cases in the SCV group (3.76%). The incidence rates of postprocedure complications were 5.20% in the BCV group and 6.58% in the SCV group and included catheter-related infections and thrombosis.

Conclusions: Ultrasound-guided cannulation of the right BCV is an effective and safe method for CVC placement in adult patients and provides an additional option for catheter access.

Keywords: brachiocephalic vein; central venous cannulation; subclavian vein; ultrasound guidance; vascular ultrasound.

Publication types

  • Comparative Study

MeSH terms

  • Brachiocephalic Veins / diagnostic imaging*
  • Catheterization, Central Venous / methods*
  • Central Venous Catheters
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Subclavian Vein / diagnostic imaging*
  • Ultrasonography, Interventional / methods*