Supraclavicular central venous catheterization.

Percutaneous central venous catheterization is a well-accepted procedure for cardiac monitoring, total parenteral nutrition, and long-term drug therapy. The supraclavicular approach was used for 90 catheterizations in 81 gynecologic patients to evaluate ease of insertion, complication rate, and patient compliance. Anatomic considerations, insertion technique, and the rationale for the supraclavicular approach are discussed in detail. A successful catheterization rate of 91% was achieved with acceptable morbidity. There were three instances each of pneumothorax, catheter malposition, and catheter infection. Advantages of the supraclavicular approach include a wider target area, a more direct route to the superior vena cava, and less pain on insertion. With reliable and constant landmarks, relative ease of and comfort on insertion, and low complication rate, the supraclavicular technique is the preferred method when percutaneous central venous catheterization is indicated.