Der Vena-subclavia-Katheter (VSK) hat sich heute in Notfallmedizin und Intensivtherapie als Vena-cava-Zugang bestens bewährt. Er ist jedoch mit einer Reihe teils schwerwiegender Komplikationen be-lastet. Die wesentlichsten sind solche durch Fehlpunktion wie Pleura-und Arterienverletzung, embolische Komplikationen wie Katheter-embolie, Luftembolie oder Thrombembolie sowie die Infektion. Ur-sache und Häufigkeit dieser Komplikationen sowie ihre Verhütung werden dargestellt. Abschlieβend wird ein Kathetermodell (Cava-fix®) vorgestellt, das in seiner Konzeption die Gefahrenquellen des VSK weitestgehend berücksichtigt. Die Vorteile des VSK gegenüber anderen Methoden des Katheterismus der Vena cava dürfen als ge-sichert gelten. Die Indikation ist wegen der genannten Komplikationen jedoch eng zu stellen.

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