Inclusion Criteria:  Cardiac surgical patients in Cardiac Surgery Intensive Care Unit Axillary vein catheterization is needed according to the clinical practice  Exclusion Criteria:  the proximal and/or distal axillary vein was not clearly visualized or potentially unavailable for catheterization; did not receive or had not received oral antiplatelet drugs and/or anticoagulants for less than 3 days; already had presence of subclavian or axillary vein catheter; required an emergency axillary vein catheterization; had fracture of the ipsilateral clavicle or anterior proximal ribs; had subclavian and/or axillary vein thrombosis; had local infection of the puncture area.