Chinese Journal of Clinical Anatomy ›› 2021, Vol. 39 ›› Issue (6): 638-641.doi: 10.13418/j.issn.1001-165x.2021.06.003

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Effect of the angle between cephalic vein and axillary vein or subclavian vein on PICC catheterization through cephalic vein approach

Chen Yuji1, Huang Lan1, Huang Jingya1, Huang Jieqing1, Zhu Ding1, Yang Zhenshui1, Liang Kun2, Wei Li3   

  1. 1. First School of Clinical Medicine, Guangxi Medical University, Nanning 530021, China; 2. Department of Emergency, the Second Affiliated Hospital of Guangxi Medical University, Nanning 530007, China;3. Department of Human Anatomy, Guangxi Medical University, Nanning 530021, China
  • Received:2020-05-17 Online:2021-11-25 Published:2021-12-01

Abstract: Objective To explore the effect of the angle between cephalic vein and axillary vein or subclavian vein on PICC catheterization through cephalic vein approach. Methods A total of 38 (76 sides) cadaver donors were dissected, and the angle changes between cephalic vein and axillary vein or subclavian vein of male or female were measured and analyzed at 0° and 90° of upper limb abduction.  Results   The average diameter of cephalic vein into the anterior lateral wall of the axillary vein or subclavian vein was (7.27±2.94) mm, 95% confidence interval (95%CI) was (6.51~8.03) mm. The included angle between cephalic vein and axillary vein or subclavian vein has the following 3 types: acute angle, right angle and obtuse angle. When the upper limb abduction reached 0°, the included angle was (47.14±27.02) ° on average, the 95% CI was 40.97°~ 63.32°. However, the upper limb abduction reached 90°, the included angle was (63.88±24.26) ° on average, which was greater than when the upper limb abduction reached 0°, and the 95% CI was 53.96°~ 65.64°. There was no significant difference in the included angles between male and female with upper limb abduction at 0°, while the included angle of male was greater than that of female with upper limb abduction at 90°. At 0° and 90° of upper limb abduction, there was no significant difference in the angle between left and right sides. Conclusions The included angle of both male and female between cephalic veins and axillary vein or subclavian vein does not affect the duct to pass through during PICC catheterization through cephalic vein approach. However, in a few cases, the included angle is close to or greater than 90°, especially the male upper limb abduction 90° may increase the difficulty of catheter passing through the included angle, which should be paid attention to during operation.

Key words: Cephalic vein,  Catheterization of vein,  Axillary vein,  Subclavian vein

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