title: Influence of orientations of guidewire tip on the placement of subclavian venous catheters.
abstract: BACKGROUND
  The 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.
  
  
  METHODS
  A 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.
  
  
  RESULTS
  There 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).
  
  
  CONCLUSIONS
  These data suggest that the orientation of the J-wire tip downward can increase successful placement rates of right subclavian venous catheterization.
authors.affiliation: Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Kyonggi, Korea.
authors.forename: H-P
authors.initials: HP
authors.lastname: Park
authors.forename: Y
authors.initials: Y
authors.lastname: Jeon
authors.forename: J-W
authors.initials: JW
authors.lastname: Hwang
authors.forename: S-H
authors.initials: SH
authors.lastname: Han
authors.forename: J-H
authors.initials: JH
authors.lastname: Bahk
authors.forename: Y-S
authors.initials: YS
authors.lastname: Oh
mesh_terms: D000368:Aged; D015992:Body Mass Index; D002405:Catheterization, Central Venous / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012727:Sex Characteristics; D013348:Subclavian Artery