title: Variable anatomical relationship of phrenic nerve and subclavian vein: clinical implication for subclavian vein catheterization.
abstract: BACKGROUND
  During subclavian vein catheterization, a potential, but rare, hazard is the phrenic nerve injury, which compromises respiratory function. We conducted a cadaver study focused on the possible anatomical relationships between the subclavian vein and the phrenic nerve.
  
  
  METHODS
  Forty-two adult cadavers (84 heminecks) were dissected. Special attention was given to the topography of the phrenic nerve and subclavian vein.
  
  
  RESULTS
  In all but three cases (81 of 84), normal topography was present, that is, the nerve was posterior to the vein. In two cases, the phrenic nerve crossed anterior to the subclavian vein and in one case traversed the anterior wall of the subclavian vein.
  
  
  CONCLUSIONS
  Variants of the relationship of the subclavian vein and the phrenic nerve should be familiar to anaesthesiologists during subclavian vein cannulation in order to achieve successful vein approach without causing phrenic nerve palsy.
authors.affiliation: Department of Anatomy, Medical School of Aristotle University of Thessaloniki, PO Box 300, 54124 Thessaloniki, Greece. g_paraskevas@yahoo.gr
authors.forename: G K
authors.initials: GK
authors.lastname: Paraskevas
authors.forename: A
authors.initials: A
authors.lastname: Raikos
authors.forename: K
authors.initials: K
authors.lastname: Chouliaras
authors.forename: B
authors.initials: B
authors.lastname: Papaziogas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010791:Phrenic Nerve / Q000033:anatomy & histology* / Q000293:injuries; D013350:Subclavian Vein / Q000033:anatomy & histology*