Development of a New Technique for Ultrasound Imaging of the Innominate Vein and the Venous Angle

Abstract

Ultrasound is a valuable tool to guide central venous access, yet it can be challenging to visualize the innominate vein (INV). The need to enhance visualization of the INV arises from investigating a new treatment for acute decompensated heart failure involving placing a device at the left venous angle to create a low-pressure zone to facilitate thoracic duct lymph flow1 (WhiteSwell). The ultrasound window is narrow because of the clavicle, and use of a small footprint microconvex probe in the supraclavicular position can be valuable,2-7 but further enhancement may be needed.