CVC complications

Q: Which site has the least chance of symptomatic thrombosis after central venous catheter (CVC) placement? - select one

A) Internal Jugular (IJ)

B) Subclvian (SC)

C) femoral

Answer: B

Although mechanical complications are more common after an attempt on the subclavian vein for central line than internal jugular and femoral veins, the subclavian central line is associated with fewer bloodstream infections and symptomatic thrombosis.

Said that SC-CVC should be ideally avoided in patients with renal insufficiency, mainly with stage 3b and above, due to the risk of central vein stenosis, particularly large bore CVCs such as dialysis catheters.

#procedures

References:

1. en LA, Narasimhan M, Berger JS, et al. Mechanical complications of central venous catheters. J Intensive Care Med 2006; 21:40.

2. ienti JJ, Mongardon N, Mégarbane B, et al. Intravascular Complications of Central Venous Catheterization by Insertion Site. N Engl J Med 2015; 373:1220.

3. Hernández D, Díaz F, Rufino M, Lorenzo V, Pérez T, Rodríguez A, De Bonis E, Losada M, González-Posada JM, Torres A. Subclavian vascular access stenosis in dialysis patients: natural history and risk factors. J Am Soc Nephrol. 1998 Aug;9(8):1507-10. doi: 10.1681/ASN.V981507. PMID: 9697674.