Ultrasound guided cannulation of the right subclavian vein via a supraclavicular approach for the placement of a ventriculoatrial shunt

Stefan Boskovic; Stefan Weber; Se-Chan Kim

doi:10.1177/11297298231175526

Ultrasound guided cannulation of the right subclavian vein via a supraclavicular approach for the placement of a ventriculoatrial shunt

J Vasc Access. 2023 May 17:11297298231175526. doi: 10.1177/11297298231175526. Online ahead of print.

Authors

Stefan Boskovic¹, Stefan Weber², Se-Chan Kim³

Affiliations

¹ Department of Anesthesiology and Intensive Care Medicine, Universitätsklinikum Bonn, Bonn, Germany.
² Department of Anesthesiology and Intensive Care Medicine, Heilig Geist Krankenhaus Köln, Cologne, Germany.
³ Department of Anesthesiology and Perioperative Medicine, Orthopädische Klinik Markgröningen GmbH, Markgroningen, Germany.

PMID: 37198871
DOI: 10.1177/11297298231175526

Abstract

Central venous cannulation is usually performed via the internal jugular vein (IJV) or subclavian vein (SclV) using the Seldinger technique. The puncture of the SclV can be achieved supraclavicular which was described by Yoffa in 1965. The original approach by Yoffa is based on anatomical landmarks. Ventriculoatrial (VA) shunts in patients suffering from hydrocephalus are becoming more common. It is the procedure of choice in patients with ventriculoperitoneal (VP) shunt complications. We present a case of a female patient with a complex cervical venous anatomy and an obscure inaccessible right internal jugular vein (IJV). Subsequently, we decided to use an ultrasound guided supraclavicular approach to the right subclavian vein for implantation of a VA shunt.

Keywords: Ventriculoatrial shunt; brachiocephalic vein; infraclavicular access; subclavian vein; supraclavicular access; ultrasonography.