Ultrasound-Guided In-Plane Subclavian Vein Puncture versus Prior Ultrasound and Landmark Technique: A Randomized Controlled Trial
Authors' conclusion
Compared with the landmark technique, the ultrasound-guided MISP technique significantly reduced the risk of complications.
Study context
- Population
- Patients scheduled for elective surgery undergoing subclavian vein central venous catheterization (CVC)
- Participants
- 101 patients
- Comparison
- MISP vs Control
- Primary endpoint
- A priori defined composite risk score (puncture attempts, required time, posterior venous wall injury, arterial punctures, hematoma, hemo-, pneumothorax, catheter mispositioning)
Primary result
Composite risk score
Mean diff
5.21
95% CI 1.71–8.71
P = 0.028
By group
MISP
6.4
mean · SD 5.9
Control
11.6
mean · SD 10.8
As reported in the abstract
Further findings
| Outcome | MISP | Control | Difference (minutes) | P value |
|---|---|---|---|---|
| Overall success rate (as-treated)As-treated | 86% (95% CI 74.6%–93.9%) | 71% (95% CI 56.2%–82.5%) | P = 0.046 | |
| Procedural timeLonger in the MISP group | 5 | P < 0.001 |
Safety
Pneumothorax
| Outcome | MISP | Control | NNH (punctures) | P value |
|---|---|---|---|---|
| Arterial puncture | 1.9% (95% CI 0.05%–10.45%) | 12% (95% CI 4.5%–24.3%) | 10 | P = 0.047 |
Original publication
Ultrasound-Guided In-Plane Subclavian Vein Puncture versus Prior Ultrasound and Landmark Technique: A Randomized Controlled Trial. Anesth Analg. Published 25 November 2025. doi:10.
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