Direct central vein puncture for silicone rubber catheter insertion. An alternative technique for Broviac catheter placement.

The indications for placement of the Broviac catheter have been expanded. Although cephalic vein cutdown has become the accepted technique for placement of the catheter, cannulation of this vein is not always possible. A technique is described for direct placement of the Broviac catheter into the subclavian or internal jugular vein. Formal venous cutdown is not required, and the technique does not sacrifice a vein. We have performed 21 consecutive catheter insertions in 20 patients without complications. It is a safe alternative method for silicone rubber catheter placement.