Ultrasound-guided, long-axis, in-plane, infraclavicular axillary vein cannulation: A 6-year experience

Abstract

Background: Despite its potential advantages, ultrasound-guided cannulation of the axillary vein in the infraclavicular area is still rarely used as an alternative to other techniques. There are few large series demonstrating the safety and feasibility of this approach. Methods: Retrospective analysis of data on patients undergoing ultrasound-guided, long-axis, in-plane infraclavicular axillary vein cannulation for the incidence of complications and the failure rate from two secondary-care hospitals. Results: The analysis included 710 successful attempts of axillary vein long-axis, in-plane, US-guided cannulation, and 24 (3.3%) failed attempts. We recorded a 96.7% success rate with an overall incidence of complications of 13%, mainly malposition (8.1%). There was one case of pneumothorax (0.14%), five cases of arterial puncture (0.7%), and two cases of brachial plexus injury. Conclusions: The US-guided axillary central venous cannulation (CVC) access technique can be undertaken successfully in patients, even in challenging circumstances. Taken together with existing work on the utility and safety of this technique, we suggest that it should be adopted more widely in clinical practice.

Association between BMI and the success rate of transaxillary venous port implantation: a retrospective cohort study

“…The higher the BMI of the patient, the deeper the location of the axillary vein [24]. Deeper veins may make it challenging to navigate the guidewire, dilators, and catheters [17]. In summary, these studies' ndings illustrate why BMI can reduce the success rate of axillary venipuncture.…”

“…However, rigorous statistical analysis was used to corroborate this occurrence using univariate, strati ed, and multiple regression models. Previous studies have also shown that because the axillary vein lacks soft tissue attachments, inhalation can lead to venous collapse, failing axillary venipuncture, or cannulation in the presence of hypovolemia [17].…”