Background: Although several procedures of subclavian venipuncture have been reported, no standard method has been established yet. The purpose of this study was to investigate some more accurate and improved blind puncture tips.

Methods: A prospective study was conducted on patients who underwent cardiac radio-frequency ablation with the blind technique of subclavian venipuncture from August 2018 to June 2022. All patients were randomly assigned to an intrathoracic approach group or extrathoracic approach group. Each group of patients followed their own specific puncture scheme and tips.

Results: About 371 punctures were included. Blind subclavian venipunctures were performed with 98.9% technical success and without complications in all patients. The overall success rate with an intrathoracic and extrathoracic approach was equivalent (96.7% vs. 98.3%, P =.23). The intrathoracic group showed a higher first-pass success compared with the extrathoracic group (91.9% vs. 80.2%, P = 0.003, respectively).

Conclusion: We localized the landmark/reference and skin puncture site of an intrathoracic and extrathoracic subclavian venipuncture individually and quantitatively. These experiences make blind techniques more accurate and faster.