The malpositioned subclavian catheter.

The results of a review of 524 consecutive infraclavicular subclavian vein catheterizations revealed inadvertent cannulization of the internal jugular vein to be a relatively common problem. No increased predilection for malpositioning was associated with either a right-sided or left-sided approach. The safety and efficacy of this repositioning technique using a guide wire, anatomic maneuvers and with and without the adjuvant use of fluoroscopy were investigated. The malpositioned subclavian vein catheter need not be removed and the patient need not undergo another percutaneous catheterization. The technique affords safe and simple repositioning of the catheter tip into the superior vena cava.