• H-P Park, Y Jeon, J-W Hwang, S-H Han, J-H Bahk, and Y-S Oh.
• Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Kyonggi, Korea.
• Acta Anaesthesiol Scand. 2005 Nov 1;49(10):1460-3.

BackgroundThe role of a J-type guidewire tip has been known to prevent vascular or cardiac wall damage. We hypothesized that the course of the guidewire may be influenced by the initial orientations of the J-type guidewire tip during the subclavian approach. The purpose of this study was to investigate the influence of the direction of the needle bevel and J-wire tip on successful placement of subclavian catheters.MethodsA total of 140 adult patients of either sex were studied. Patients were randomly divided by the direction of the needle bevel (neutral vs. downward) and the direction of the J-wire tip (upward vs. downward). Under general anesthesia, right infraclavicular subclavian catheterization was attempted using the Seldinger technique.ResultsThere was no statistically significant difference among the successful and unsuccessful placements in relation to factors including sex, body mass index, and needle bevel direction. The success rate was high when the J-wire tip was directed downward (P = 0.001).ConclusionThese data suggest that the orientation of the J-wire tip downward can increase successful placement rates of right subclavian venous catheterization.

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