A technique to access difficult to find upper extremity veins for right heart catheterization: the levogram technique.

Upper extremity venous access provides a safer alternative for performance of right heart catheterization compared to femoral venous access. We describe a technique to access deep veins of the upper extremity, in patients undergoing transradial catheterization, using levophase contrast venography. This technique allows the operator to access deep veins of the upper extremity without the need for additional equipment, staff or training, using traditional basic catheterization laboratory skills and equipment.