Sonographic Safety Margins of Subclavian Vein: Effect of View and Arm Position

NCT07556770 | Not Yet Recruiting

• 1 other identifier: 2026-0533
• Study Type: observational
• Target: 55
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this observational study is to evaluate and compare the anatomical safety margins of the subclavian vein using ultrasound. Medical professionals commonly use the subclavian vein to insert central venous catheters, but nearby vulnerable structures, such as the lung and artery, can be at risk during the procedure. This study investigates two different ultrasound probe positions: supraclavicular (above the collarbone) and infraclavicular (below the collarbone). It also examines how changing the patient's arm position (from resting in a neutral position to being raised at a 90-degree angle) affects the distance between the vein and these vulnerable structures. Participants are adult patients scheduled for surgery under general anesthesia who already require ultrasound-guided vascular access. Immediately after falling asleep from anesthesia, researchers will perform a brief 3 to 5-minute ultrasound scan of the collarbone area. This is a strictly non-invasive imaging study; no research-related needle punctures or catheter insertions will be performed. The findings aim to provide robust anatomical evidence to make future vascular procedures safer for patients.

Conditions

General Anesthesia Induction for Elective Surgery; Sono Guided Catheterization

Outcome Measures

Primary Outcomes (1)

• Shortest Distance Between the Subclavian Vein (SCV) and Subclavian Artery (SCA)

  The shortest anatomical distance between the SCV and SCA is measured in the neutral arm position to evaluate the safety margin. The difference between the supraclavicular (SC) and infraclavicular (IC) views will be analyzed using a paired t-test or Wilcoxon signed-rank test.

  Immediately after the induction of general anesthesia (within 3 to 5 minutes)

Secondary Outcomes (4)

• Sonographic Continuous Variables of the SCV and Adjacent Structures

  Immediately after the induction of general anesthesia (within 3 to 5 minutes)

• Sonographic Cross-Sectional Area (CSA) Variables of the SCV and Adjacent Structures

  Immediately after the induction of general anesthesia (within 3 to 5 minutes)

• Sonographic Proportion and Index Variables of the SCV and Adjacent Structures

  Immediately after the induction of general anesthesia (within 3 to 5 minutes)

• Relative Position of the Subclavian Artery (SCA) to the Subclavian Vein (SCV)

  Immediately after the induction of general anesthesia (within 3 to 5 minutes)

Study Arms (1)

Observation Group

Adult patients undergoing general anesthesia who are scheduled for ultrasound-guided vascular catheterization.

Other: Non-invasive sonographic observation

Interventions

Non-invasive sonographic observation OTHER

Non-invasive ultrasound measurement of anatomical safety margins of the subclavian vein and adjacent structures, comparing supraclavicular and infraclavicular views in neutral and abducted arm positions.

Observation Group

Eligibility Criteria

• Age: 20 Years - 79 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Need for ultrasound-guided vascular access for general anesthesia

You may qualify if:

• Patients requiring ultrasound-guided vascular procedures.
• Age between 20 and 79 years.
• Patients who have voluntarily provided written informed consent for this clinical study.
• American Society of Anesthesiologists (ASA) physical status classification I, II, or III.

You may not qualify if:

• Anatomical variations of the clavicle (e.g., history of clavicle fracture).
• Suspected thrombosis at the target site.
• Known anatomical abnormalities of the subclavian vein or artery.
• Inability to abduct the arm (e.g., due to shoulder joint abnormalities).
• Patient refusal to participate.

Sponsors & Collaborators

• Asan Medical Center: lead

Study Sites (1)

Asan Medical Center

Seoul, 05505, South Korea

Location

Related Publications (13)

• McGee DC, Gould MK. Preventing complications of central venous catheterization. N Engl J Med. 2003 Mar 20;348(12):1123-33. doi: 10.1056/NEJMra011883. No abstract available.

  PMID: 12646670 BACKGROUND

• Saugel B, Scheeren TWL, Teboul JL. Ultrasound-guided central venous catheter placement: a structured review and recommendations for clinical practice. Crit Care. 2017 Aug 28;21(1):225. doi: 10.1186/s13054-017-1814-y.

  PMID: 28844205 BACKGROUND

• Comerlato PH, Rebelatto TF, Santiago de Almeida FA, Klein LB, Boniatti MM, Schaan BD, Rados DV. Complications of central venous catheter insertion in a teaching hospital. Rev Assoc Med Bras (1992). 2017 Jul;63(7):613-620. doi: 10.1590/1806-9282.63.07.613.

  PMID: 28977087 BACKGROUND

• Sadek M, Roger C, Bastide S, Jeannes P, Solecki K, de Jong A, Buzancais G, Elotmani L, Ripart J, Lefrant JY, Bobbia X, Muller L. The Influence of Arm Positioning on Ultrasonic Visualization of the Subclavian Vein: An Anatomical Ultrasound Study in Healthy Volunteers. Anesth Analg. 2016 Jul;123(1):129-32. doi: 10.1213/ANE.0000000000001327.

  PMID: 27149016 BACKGROUND

• Vezzani A, Manca T, Brusasco C, Santori G, Cantadori L, Ramelli A, Gonzi G, Nicolini F, Gherli T, Corradi F. A randomized clinical trial of ultrasound-guided infra-clavicular cannulation of the subclavian vein in cardiac surgical patients: short-axis versus long-axis approach. Intensive Care Med. 2017 Nov;43(11):1594-1601. doi: 10.1007/s00134-017-4756-6. Epub 2017 Mar 13.

  PMID: 28289815 BACKGROUND

• Prasad R, Soni S, Janweja S, Rajpurohit JS, Nivas R, Kumar J. Supraclavicular or infraclavicular subclavian vein: Which way to go- A prospective randomized controlled trial comparing catheterization dynamics using ultrasound guidance. Indian J Anaesth. 2020 Apr;64(4):292-298. doi: 10.4103/ija.IJA_930_19. Epub 2020 Mar 28.

  PMID: 32489203 BACKGROUND

• Jaiswal P, Saini S, Chhabra PH. Subclavian Vein Cannulation via Supraclavicular or Infraclavicular Route Which is Better? A Prospective Randomized Controlled Trial. Indian J Crit Care Med. 2024 Apr;28(4):375-380. doi: 10.5005/jp-journals-10071-24686.

  PMID: 38585307 BACKGROUND

• Byon HJ, Lee GW, Lee JH, Park YH, Kim HS, Kim CS, Kim JT. Comparison between ultrasound-guided supraclavicular and infraclavicular approaches for subclavian venous catheterization in children--a randomized trial. Br J Anaesth. 2013 Nov;111(5):788-92. doi: 10.1093/bja/aet202. Epub 2013 Jun 10.

  PMID: 23756247 BACKGROUND

• Bojic A, Steiner I, Gamper J, Schellongowski P, Lamm W, Hermann A, Riss K, Robak O, Staudinger T. Supraclavicular Approach to the Subclavian Vein as an Alternative Venous Access Site for ECMO Cannulae? A Retrospective Comparison. ASAIO J. 2017 Sep/Oct;63(5):679-683. doi: 10.1097/MAT.0000000000000529.

  PMID: 28125465 BACKGROUND

• Safdar N, Kluger DM, Maki DG. A review of risk factors for catheter-related bloodstream infection caused by percutaneously inserted, noncuffed central venous catheters: implications for preventive strategies. Medicine (Baltimore). 2002 Nov;81(6):466-79. doi: 10.1097/00005792-200211000-00007.

  PMID: 12441903 BACKGROUND

• Parienti JJ, Mongardon N, Megarbane B, Mira JP, Kalfon P, Gros A, Marque S, Thuong M, Pottier V, Ramakers M, Savary B, Seguin A, Valette X, Terzi N, Sauneuf B, Cattoir V, Mermel LA, du Cheyron D; 3SITES Study Group. Intravascular Complications of Central Venous Catheterization by Insertion Site. N Engl J Med. 2015 Sep 24;373(13):1220-9. doi: 10.1056/NEJMoa1500964.

  PMID: 26398070 BACKGROUND

• Vogel JA, Haukoos JS, Erickson CL, Liao MM, Theoret J, Sanz GE, Kendall J. Is long-axis view superior to short-axis view in ultrasound-guided central venous catheterization? Crit Care Med. 2015 Apr;43(4):832-9. doi: 10.1097/CCM.0000000000000823.

  PMID: 25517477 BACKGROUND

• Raad I. Intravascular-catheter-related infections. Lancet. 1998 Mar 21;351(9106):893-8. doi: 10.1016/S0140-6736(97)10006-X. No abstract available.

  PMID: 9525387 BACKGROUND

Central Study Contacts

Jun-Young Park, MD, PhD

CONTACT

82-10-9920-0532; parkjy@amc.seoul.kr

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: April 22, 2026
• First Posted: April 29, 2026
• Study Start: April 23, 2026
• Primary Completion (Estimated): July 15, 2026
• Study Completion (Estimated): July 15, 2026
• Last Updated: May 5, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

KR (1)