Supine Position Popliteal Vein Puncture Under Ultrasound Guidance Is a Feasible and Effective Strategy to Establish Venous Access

Background

This study aims to introduce the clinical application value of popliteal vein puncture in the supine position under ultrasound guidance and compare this method with popliteal vein puncture in the prone position.

Methods

Endovascular operations for nonthrombotic iliac vein lesion patients using popliteal vein access were performed during the period from July 2019 to August 2022 at the Zhongshan Hospital (Xiamen), Fudan University, and Shanghai Xuhui District Central Hospital. Patients were randomly divided into supine position group and prone position group. All of the patients were punctured under ultrasound guidance. The procedure duration time for popliteal vein puncture, visual analog scale (VAS) scores, and postoperative complications were recorded and compared between the 2 groups.

Results

Totally 120 patients were included in this study, in which 60 patients were enrolled in the supine position group and 60 patients were enrolled in the prone position group. The median procedure time from puncture to iliofemoral venography was 5.97 min (interquartile range 5.78 min–6.03 min) and 28.76 min (interquartile range 26.84 min–29.83 min; P < 0.01 (in the supine position and prone position group, respectively. The median time from puncture to access sheath insertion was 5.05 min (interquartile range 4.88 min–5.13 min) and 5.03 min (interquartile range 4.93 min–5.12 min; P = 0.607) in the supine position and prone position groups, respectively. The median VAS value was 3 (interquartile range 2–3) and 8 (interquartile range 7–9, P < 0.01) in the supine position and prone position groups, respectively. In the supine position group, one case of arterial branch injury was observed after operation and was successfully managed by ultrasound-guided compression.

Conclusions

Popliteal vein puncture in the supine position under ultrasound guidance is safe, significantly reduces the overall operation time without changing position, and relieves the discomfort of patients.