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To the Editor:—
Drs. Schapiro and Stern's report of four complications during subclavian vein cannulation (201:327, 1967) adds to a growing list, which obviously reflects this procedure's increasing popularity. Before it is unconditionally condemned, however, certain points should be emphasized. The complications from any procedure will vary with the skill of the operator and with attention to detail and understanding of what is involved.In this light it would be well for those who will be doing subclavian cannulations to spend an hour or so in the autopsy room with their needles and catheters, and observe exactly how much leeway they have during the procedure, especially in reference to the apex of the lung. It will be noted that once the needle begins its journey beneath the clavicale, failure to maintain a trajectory plane exactly parallel to the frontal plane of the body will indeed result in entry into
Law DC. Subclavian Vein Cannulation. JAMA. 1967;202(3):246. doi:10.1001/jama.1967.03130160120040