Subclavian vein catheterization for apheresis access.

We have inserted Shiley Vas-Caths into the subclavian veins of 20 patients. These indwelling catheters are used for apheresis and some were maintained up to 3 months. Of the 430 apheresis procedures performed, 30 (6.9%) had good peripheral vein access while 400 (93.1%) required subclavian vein catheterization. No complications, including infection and blood clotting, have been recorded. The only contamination noted was normal skin flora cultured on the outside of the exposed portion of the cannula. We attribute our success to limited catheter manipulation, frequent dressing changes, and adhering to strict, sterile procedures.