Mechanical complications of subclavian vein catheterization. A prospective study.

Subclavian vein catheterization, a timesaving, convenient and easy method of central venous access is not free of complications. In this report 150 consecutive infraclavicular subclavian vein catheterization attempts were evaluated with regard to noninfectious complications. 95.3% of the patients were successfully catheterized. While the overall complication rate was 29.3%, major complications occurred in 2.6%. The complication rate in right-sided attempts (35.5%) was significantly higher than in left-sided attempts (12.5%) (p less than 0.01). All of the major complications occurred in right-sided attempts. Left sided attempts seem to be safer unless specific contraindications exist. Malpositionings were the most common complications (16%) and were easily identified and managed by routine postprocedure chest X-rays. The mortality rate was 0%. As a result we think that this procedure will still remain as a valuable central venous catheterization method in experienced hands with proper indications and prompt treatment in the case of complications.