MISP Technique Is Safer, More Effective Than Landmark Technique for Subclavian Vein Catheterization

Background: Central venous access via the subclavian vein remains a commonly performed procedure in perioperative and critical care settings, valued for patient comfort and relatively low infection risk. Despite these advantages, clinicians often hesitate to use this site because of potentially serious complications, including arterial puncture and pneumothorax. Advances in ultrasound technology have enabled more precise visualization of vascular anatomy, raising the possibility of improving both safety and procedural success compared to traditional landmark-based approaches. Objective: To determine whether an ultrasound-guided microconvex in-plane subclavian puncture (MISP) technique improves procedural safety and effectiveness compared to a landmark-based approach preceded by ultrasound scanning. Design: Randomized controlled trial. Participants: 101 adult patients undergoing elective abdominal surgery and who required central venous catheter placement. Methods: Participants were a more...