This randomized controlled trial compared two methods for placing catheters into subclavian veins before elective surgery. One hundred one patients were scheduled for this procedure. Researchers tested an ultrasound-guided microconvex in-plane subclavian puncture against a standard landmark technique that used an ultrasound prescan.
The study found that the ultrasound-guided method significantly lowered a composite risk score. This score included measures like puncture attempts, time required, and risks of injury to the vein wall or artery. Success rates were also significantly higher with the ultrasound-guided approach. Specifically, 86 percent of procedures succeeded compared to 71 percent with the landmark technique.
Safety results showed a lower risk of arterial punctures with the new method. However, the ultrasound-guided procedure took about five minutes longer on average. One case of pneumothorax occurred in each group, and one case of posterior venous wall injury was noted. The authors suggest further studies are needed to evaluate using this technique as a standard approach.