[Complications of the subclavian vascular approach for hemodialysis].

The authors report their experience of subclavian vein catheterisation and compare their results with those of previously reported series. One hundred and sixty-four subclavian catheters were inserted in 111 patients, 66 with acute renal failure and 49 with chronic renal failure. The total number of hemodialysis sessions was 984. The catheters were left in situ for an average of 14.5 +/- 2 days or 19 +/- 2 patient days. The main immediate complications were pneumothorax (1 case) and subclavian artery puncture (2 cases). Seventeen catheters were complicated by septicemia with one fatal outcome. In addition, 5 cases of subclavian vein thrombosis, diagnosed clinically and confirmed by venography, were observed. Percutaneous subclavian vein catheterisation is a useful technique for emergency renal dialysis. However, septic and thrombotic complications are fairly frequent and potentially serious. Although measures can be taken to reduce the risk of infection, the prevention of thrombosis seems to be more difficult.