Use of a split-sheath vein introducer for subclavian venipuncture in the placement of silicone catheters for chronic venous access.

The technique of venous cutdown for placement of silicone catheters can be difficult, uncomfortable for the patient, and very time-consuming. Adapting a technique used for the placement of permanent transvenous pacemaker leads, subclavian venotomy and a split-sheath dilator can be used for direct placement of large-bore catheters into the superior vena cava. This approach decreases patient discomfort and the likelihood of infectious or hemorrhagic complications of silicone catheter placement, and has greatly simplified and shortened this procedure.