Anatomical Bases of the Mechanical Complications during the Positioning of Subclavian Catheters

The subclavian vein is located at the edge of scalenecosto-clavicular triangle, surrounded by the medial aspect of the clavicle in its anterior side, the first rib on its underside and the anterior scalene muscle in his back side. Subclavian catheterization by puncture is not a harmless procedure, in fact, is the path that shows more of major mechanical complications. The main mechanical complications observed with the subclavian approach are the development of uncomplicated supraclavicular hematoma (5%) and pneumothorax (1.5 - 3%). The fact of not having in mind the concept of proximity of the subclavian vein with the subclavian artery and the lung, favors the occurrence of such complications. The aim of this work is to show the structures involved in more frequent mechanical complications of percutaneous subclavian venous catheters.We used human cadaveric material, preserved in formaldehyde 10%, in which conventional and special dissected supra-and infraclavicular regions showing subclavian vein and adjacent structures.Through dissection of supraclavicular and infraclavicular regions was achieved by a proper display of the morphology of the subclavian vein and surrounding structures to be taken into account while performing the puncture of the vein and the development of complications.Considering that the puncture of the subclavian vein is a blind procedure where the vein can not be seen through the skin or palpated, it is essential to accurate knowledge of the anatomical relations of the region to successfully channel the vein and lower the risk of mechanical complications.