Experience with Subclavian Vein for Vascular Access

We report our experience with the subclavian vein as a route for temporary vascular access. By modifying the technique described by Uldall one can place these catheters at the bedside without the need of a separate exit tunnel. They are easily maintained in place and allow for early discharge home while awaiting permanent vascular access maturation.The results of approximately 600 dialysis treatments showed adequate clearence with a mean postdialysis drop in creatinine of 5.0mg./dl. and BUN of 46mg./dl. Complication rates were minimal with no hemo or pneumothorax. The rate of complications between bedside and operating room placement was not different. We feel the low complication rate, the east of insertion, and the patency at home makes this an attractive alternative to other means of temporary dialysis such as: peritoneal dialysis, repeat femoral vein catheterization or arteriovenous shunts.