Subclavian vein cannulation

The internal transjugular approach was successful in 59 free-floating and 187 exposed leads as crossover from the venous entry approach. In two patients, due to failure to cannulate either the right or the left internal jugular vein, we used the right subclavian vein. Using this approach, 246 leads were completely removed. The procedure was partially successful in seven leads and unsuccessful in two. In the group with exposed leads, the approach increased the success rate from 90.3% to 98.3%. 

C. Secure venous access. Antecubital or forearm veins are usually easy to cannulate. Alternative sites include femoral, subclavian, internal jugular, or other central veins. Access to central veins is technically more difficult but allows measurement of central venous pressure and placement of a pacemaker or pulmonary artery lines. 

Kaiser CW, et al. Choice of route for central venous cannulation subclavian or internal jugular vein a prospective randomized study. J Surg Oncol 1981 17 345. 

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