Supraclavicular subclavian vein catheterization: modified landmarks for needle insertion.

STUDY OBJECTIVE: Identification of reliable landmarks for supraclavicular subclavian vein catheterization that requires no patient manipulation and is easily located.

PATIENT POPULATION: Thirty-five fresh human cadavers.

DESIGN AND METHODS: Descriptive study of percutaneous guide wire placement into the subclavian vein using as a new landmark the junction of middle and medial thirds of the clavicle. The position of the guide wire was confirmed by palpation of the wire in the subclavian vein during autopsy.

RESULTS: Successful placement of a guide wire into the subclavian vein occurred in 33 of 35 cadavers (94%) using the new landmark.

CONCLUSION: The new landmark for supraclavicular subclavian vein catheterization is reliable, requires no patient manipulation, and is as successful as the standard landmarks.