Deep brachial vein catheterization for total parenteral nutrition--an alternate approach: review of 154 cases.

The relative safety of silicon rubber catheters allows us to use deep brachial vein catheterization when other vascular accesses are hazardous or impossible. The vein is isolated from nerve and artery after a small incision is made across the inner edge of the brachial biceps. From January 1980 until April 1982, 154 catheters were inserted and remained in place from 14-167 days. In four instances the catheter had to be replaced because the tip was not in the superior vena cava. Twice bleeding had to be controlled with an occlusive bandage. We had no incidence of clinical thrombosis. The surgical access to the deep brachial vein provides a simple and safe method for difficult and even long-term vascular access.