Subclavian arteriovenous fistula 2 and aneurysm 3 formation following inadvertent subclavian arterial puncture have both been described. Inadvertent internal mammary arterial puncture. Thus, it can be argued that an ipsilateral subclavian approach to the central circulation is contraindicated in patients undergoing internal mammary artery grafting in case the origin of the IMA is damaged. Although damage to a pre-existing mammary graft during attempted subclavian venepuncture on the same side has not been reported, it seems reasonable to suggest that the presence of a patent graft be regarded as an absolute contraindication to subclavian venous catheterisation on that side. Similarly, the approach is relatively contraindicated in the presence of an aortic arch aneurysm.
Pneumothorax is one of the most common major complications of the technique.
It occurs more commonly in thin patients and in those with hyperexpanded chests. Venous Air Embolism. This complication is addressed in the section devoted to the complications of internal jugular venepuncture. It has been reported as a lethal complication of subclavian venepuncture 12 . Thoracic duct injury.