Long-term experience with the technique of subclavian and femoral vein cannulation in hemodialysis.

Large vein cannulation for hemodialysis was used in 1164 patients undergoing dialysis treatment and in an acute dialysis program. Subclavian vein cannulation was utilized in 2494 dialyses, and femoral vein cannulation was used in 2368 dialyses. No significant differences with regard to clinical complications were encountered in either type of cannulation. The mortality rate due to subclavian vein cannulation was 0.12%, while that due to femoral vein cannulation was 0.04%. The main risk of subclavian vein cannulation was arterial bleeding, due to trauma to an artery, and pneumothorax, more likely occurring in asthenic patients or in patients with emphysema. Single-needle hemodialysis using subclavian or femoral vein cannulation gave the same results as the arteriovenous Cimino fistula. Intermittent or combined use of both types of large vein cannulation is advantageous in long-term regular dialysis patients that are waiting for a new fistula.