The journal of vascular access
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Hemodialysis patients with suspected central vein stenosis or occlusion require venographic assessment before access surgery. Conventional venography may be unsatisfactory because of the limited ability to image central veins via peripheral arm veins that are inadequate or that have been damaged by multiple cannulations. Imaging of the central veins requires high flow contrast injection, which may be unattainable through small peripheral veins. We suggest a simple technique to improve central vein imaging by ultrasound-guided direct puncture of the basilic vein at its entry to the axilla. ⋯ Venography by Doppler ultrasound-guided direct basilic-axillary vein puncture is a simple and rapidly performed technique that improves the visualization of the central veins.