Access times for supraclavicular and infraclavicular approaches of subclavian vein catheterization in pacemaker insertion

OBJECTIVE: Infraclavicular (IC) approach of subclavian vein (SCV) catheterization is widely used as compared to supraclavicular (SC) approach for pacemaker insertion. The aim of the study was to compare the ease of catheterization of SCV using SC versus IC approach and also record the incidence of complications related to the approach. METHODS: In the prospective and interventional study, 102 patients enrolled were randomly divided into two groups. In one group, the right SCV catheterization was performed using SC approach, and in the other group, catheterization was performed using IC approach. The total number of participants, who fulfilled the requirements, was 92. Access time, success rate of cannulation, number of attempts to cannulate vein, ease of guidewire and catheter insertion, placement of temporary wire as cine time, patient comfort, and associated complications were recorded. The data collected were analyzed on SPSS software version 26. RESULTS: The SC approach had a lesser access time as compared to IC approach and this was found to be significant. Non-significant parameters included complications, number of attempts, and cine time. Only one patient from the IC group developed pneumothorax. CONCLUSIONS: The SC approach of SCV catheterization is comparable to IC approach in terms of landmark accessibility, success rate, and rate of complications. However, IC approach is less feasible in terms of time constraint and is, therefore, less likely to be successful.