On Jun. 1, 1962, Kurt Amplatz and Richard Harner published “A New Subclavian Artery Catheterization Technic” in Radiology. Amplatz, M.D., who was a professor of radiology at the University of Minnesota from 1957 to 1997, was a world-renowned pioneer in interventional radiology and pediatric cardiology.

They reported that subclavian angiography via percutaneous retrograde catheterization of the brachial artery proved to be a valuable procedure, but in the presence of arterial spasm this technic is difficult. Thrombosis of the brachial artery was observed in 4 of their patients.

Harner developed a simple method of infraclavicular subclavian artery puncture, which proved to be safe in a large group of patients. A needle is passed through the skin at a point just lateral to the midclavicular line and inferior to a line passing transversely through the sternal notch toward the third portion of the subclavian artery. The artery is palpated in the supraclavicular fossa with the index finger of the free hand. Since by this infraclavicular route the puncture is made almost parallel to the artery, the needle can be advanced into its second portion close to the origin of the vertebral artery.

Though infraclavicular needle puncture of the third portion of the subclavian artery proved useful for demonstration of the vertebrobasilar system, filling of the right carotid artery was inconstant, and extravasation of contrast medium occurred. These drawbacks were overcome by a simple intravascular catheterization technic, still using the infraclavicular artery approach, allowing satisfactory visualization of the right carotid and even the aortic arch.