Experience with Subclavian Vein for Vascular Access

Abstract

We report our experience with the subclavian vein as a route for temporary vascular access. By modifying the technique described by Uldall one can place these catheters at the bedside without the need of a separate exit tunnel. They are easily maintained in place and allow for early discharge home while awaiting permanent vascular access maturation. The results of approximately 600 dialysis treatments showed adequate clearence with a mean postdialysis drop in creatinine of 5.0mg./dl. and BUN of 46mg./dl. Complication rates were minimal with no hemo or pneumothorax. The rate of complications between bedside and operating room placement was not different. We feel the low complication rate, the ease of insertion, and the patency at home makes this an attractive alternative to other means of temporary dialysis such as: peritoneal dialysis, repeat femoral vein catheterization or arteriovenous shunts.

Delayed Onset of Hemothorax: An Unusual Complication of Subclavian Access for Hemodialysis

“…Some consider it the preferred method for newly discovered uremic patients and for chronic renal failure patients with a clotted fistula or shunt. Use of this technique has been described in 292 patients, of whom 4 have died from complications directly attributable to the procedure (table I) [1,3,[5][6][7]10]. In addition to the reported series summarized in table I, Fine el al.…”