Sharma A. , Bodenham A.R. , Mallick A. British Journal of Anaesthesia

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Presentation transcript:

Ultrasound-guided infraclavicular axillary vein cannulation for central venous access† Sharma A. , Bodenham A.R. , Mallick A. British Journal of Anaesthesia Volume 93, Issue 2, Pages 188-192 (August 2004) DOI: 10.1093/bja/aeh187 Copyright © 2004 British Journal of Anaesthesia Terms and Conditions

Fig 1 Approach to the right axillary vein. The ultrasound probe (U) in a sterile sheath has been used to show the axillary vessels in cross-section. Note the steep angle of approach and insertion depth of the introducing needle (length 7 cm) via the skin puncture site (A). Blood has been aspirated into the syringe after the needle enters the vein. British Journal of Anaesthesia 2004 93, 188-192DOI: (10.1093/bja/aeh187) Copyright © 2004 British Journal of Anaesthesia Terms and Conditions

Fig 2 This cross-sectional ultrasound image of the right infraclavicular area shows the right axillary vein (V) in the centre of the screen and the artery (A) deeper and superiorly. The path of the advancing needle is seen above the vein. The white arrow shows the approximate needle-tip position. The needle position is easier to see when it is being moved during real-time imaging. British Journal of Anaesthesia 2004 93, 188-192DOI: (10.1093/bja/aeh187) Copyright © 2004 British Journal of Anaesthesia Terms and Conditions

Fig 3 A patient with a single-lumen Hickman catheter inserted via the right infraclavicular axillary vein. Surface markings (sternal notch and right clavicle) have been drawn with a sterile marker. Point H represents an approximate traditional skin landmark site for subclavian vein puncture. The site of axillary vein puncture is seen further laterally with one suture. The exit site of the tunnelled catheter is more inferior on the anterior chest wall. British Journal of Anaesthesia 2004 93, 188-192DOI: (10.1093/bja/aeh187) Copyright © 2004 British Journal of Anaesthesia Terms and Conditions

Fig 4 A fluoroscopy image after insertion of an introducing needle (N) into the right axillary vein. The tip of the needle is just lateral to the jet of X-ray contrast shown by the tip of the white arrow. A small volume of injected X-ray contrast delineates the axillary vein draining into the subclavian vein (V) and superior vena cava. Paravalvular venous sinuses are seen just medial to the needle tip. C=clavicle; R=first rib. British Journal of Anaesthesia 2004 93, 188-192DOI: (10.1093/bja/aeh187) Copyright © 2004 British Journal of Anaesthesia Terms and Conditions