Skip to content


Critical Care

Open Access

Real-time ultrasound-guided subclavian vein cannulation in cardiac surgery: comparison between short-axis and long-axis techniques

  • F Corradi1,
  • T Manca2,
  • C Brusasco3,
  • F Cocconcelli2,
  • A Agostinelli2,
  • F Benassi2,
  • T Gherli2 and
  • A Vezzani2
Critical Care201418(Suppl 1):P132

Published: 17 March 2014


Central venous catheters play an important role in patient care; however, their use is associated with various complications and more frequently through the subclavian vein (SCV) route. A previous study showed that ultrasound-guided cannulation of the SCV in critical care patients is superior to the landmark method and should be the method of choice in these patients [1]. The aim of this study was to compare short-axis and long-axis approaches for ultrasound-guided subclavian vein cannulation with respect to indicators of success.


Eighty-three patients undergoing cardiac surgery and requiring central venous cannulation were randomized to receive long- axis or short-axis ultrasound-guided cannulation of the subclavian vein by a skilled anesthesiologist. First-pass success, unsuccessful placement, number of attempts, number of needle passes, skin and vessel puncture, time to successful catheterization and complications were considered as outcomes.


The subclavian vein was successfully cannulated by ultrasound- guided techniques in all patients. Central venous cannulation failed in two and 10 cases respectively with short-axis and long-axis view and the other view was used successfully. The first-pass success rate was significantly higher in the short-axis group (73%) compared with the long-axis group (40%) (P = 0.005). The procedure time, number of attempts, needle redirection, and skin and vessel punctures were significantly lower in the short-axis than long-axis group (P < 0.05). The overall number of complications did not differ significantly between groups even if artery puncture and hematoma occurred more frequently in the long-axis group. Moreover, the need to change the ultrasound- guided insertion technique was more frequent in the long-axis group.


Ultrasound-guided subclavian vein cannulation by an experienced operator has a higher first-pass success rate and lower access time using the short-axis than long-axis approach.

Authors’ Affiliations

Ente Ospedaliero Ospedali Galliera Genova, Italy
Azienda Ospedaliero- Universitaria di Parma, Italy
Università degli Studi di Genova, Italy


  1. Fragou M, Gravvanis A, Dimitriou V, Papalois A, Kouraklis G, Karabinis A, Saranteas T, Poularas J, Papanikolaou J, Davlouros P, Labropoulos N, Karakitsos D: Real-time ultrasound-guided subclavian vein cannulation versus the landmark method in critical care patients: a prospective randomized study. Crit Care Med 2011, 39: 1607-1612. 10.1097/CCM.0b013e318218a1aeView ArticlePubMedGoogle Scholar


© Corradi et al.; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.