Abstract
Purpose
To demonstrate the anatomic relationship of the internal jugular vein (IJV) with the common carotid artery (CCA) in order to avoid inadvertent puncture of the CCA during percutaneous central venous access or transjugular interventional procedures.
Methods
One hundred and eighty-eight consecutive patients requiring either central venous access or interventional procedures via the IJV were included in the analysis. The position of the IJV in relation to the CCA was demonstrated by portable ultrasonography. The IJV location was recorded in a clock-dial system using the carotid as the center of the dial and the angles were measured. Outcomes of the procedure were also recorded.
Results
The IJV was lateral to the CCA in 187 of 188 patients and medial to the CCA in one patient. The left IJV was at the 12 o’clock position in 12 patients (6%), the 11 o’clock position in 17 patients (9%), the 10 o’clock position in 142 patients (75%) and at the 9 o’clock position in 17 patients (9%). The right IJV was at the 12 o’clock position in 8 patients (4%), the 1 o’clock position in 31 patients (16%), the 2 o’clock position in 134 patients (71%) and the 3 o’clock position in 17 patients (9%). In one patient the left IJV was located approximately 60° medial to the left CCA; this was recorded as 2 o’clock on the left since it is opposite to the 10 o’clock position.
Conclusion
Knowledge of the IJV anatomy and relationship to the CCA is important information for the operator performing an IJV puncture, to potentially reduce the chance of laceration of the CCA and avoid placement of a large catheter within a critical artery, even when ultrasound guidance is used.
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References
R Uflacker (1997) Veins of the head and neck R Uflacker (Eds) Atlas of vascular anatomy: An angiographic approach Williams and Wilkins Baltimore 81–112
D Dolla F Cavatorta S Galli et al. (2001) ArticleTitleAnatomical variations of the internal jugular vein non-uremic outpatients J Vasc Access 2 60–63
JG Caridi IF Hawkins SuffixJr BN Wiechmann et al. (1998) ArticleTitleSonographic guidance, when using the right internal jugular vein for central vein access AJR Am J Roentgenol 171 1259–1263 Occurrence Handle1:STN:280:DyaK1M%2Fhtlajsw%3D%3D Occurrence Handle9798857
SE Mitchell RA Clark (1979) ArticleTitleComplications of central venous catheterization AJR Am J Roentgenol 133 467–476 Occurrence Handle1:STN:280:CSaB38fntlM%3D Occurrence Handle111506
VP Khatri S Wagner-Sevy MH Espinosa et al. (2001) ArticleTitleThe internal jugular vein maintains its regional anatomy and patency after carotid endarterectomy: A prospective study Ann Surg 233 282–286 Occurrence Handle10.1097/00000658-200102000-00019 Occurrence Handle1:STN:280:DC%2BD3M7ls1Slsg%3D%3D Occurrence Handle11176136
JC Horrow S Metz D Thickman et al. (1987) ArticleTitlePrior carotid surgery does not affect the reliability of landmarks for location of the internal jugular vein Anesth Analg 66 452–456 Occurrence Handle1:STN:280:BiiB3M7htlI%3D Occurrence Handle3555165
PJ Armstrong R Sutherland DH Scott (1994) ArticleTitleThe effect of position and different manoeuvres on internal jugular vein diameter size Acta Anaesthesiol Scand 38 229–231 Occurrence Handle1:STN:280:ByuB1MrjslY%3D Occurrence Handle8023661
B Docktor CB So JC Saliken et al. (1996) ArticleTitleUltrasound monitoring in cannulation of the internal jugular vein: Anatomic and technical considerations Can Assoc Radiol J 47 195–201 Occurrence Handle1:STN:280:BymB3Mjls10%3D Occurrence Handle8640417
ML Skolnick (1994) ArticleTitleThe role of sonography in the placement and management of jugular and subclavian central venous catheters AJR Am J Roentgenol 163 291–295 Occurrence Handle1:STN:280:ByuA3M7htVE%3D Occurrence Handle8037017
Conz PA, Dissegna D, Rodighiero MP, et al.(1997) Cannulation of the internal jugular vein: Comparison of the classic Seldinger technique and an ultrasound guided method. J Nephrol 311–313
KJ Heath J Woulfe S Lownie et al. (1998) ArticleTitleA devastating complication of inadvertent carotid artery puncture Anesthesiology 89 1273–1275 Occurrence Handle10.1097/00000542-199811000-00035 Occurrence Handle1:STN:280:DyaK1M%2FjslyitQ%3D%3D Occurrence Handle9822023
MA Sloan JD Mueller LS Adelman et al. (1991) ArticleTitleFatal brainstem stroke following internal jugular vein catheterization Neurology 41 1092–1095 Occurrence Handle1:STN:280:By6B1Mnht1c%3D Occurrence Handle2067639
CD Blitt WA Wright (1974) ArticleTitleAn unusual complication of percutaneous internal jugular vein cannulation: Puncture of an endotracheal tube cuff Anesthesiology 40 306–307 Occurrence Handle1:STN:280:CSuC3cjhs1E%3D Occurrence Handle4814255
FS Silva (2003) ArticleTitleNeck haematoma and airway obstruction in a patient with goiter: Complication of internal jugular vein cannulation Acta Anaesthesiol Scand 47 626–629 Occurrence Handle10.1034/j.1399-6576.2003.00106.x Occurrence Handle1:STN:280:DC%2BD3s7otV2juw%3D%3D Occurrence Handle12699526
BS Lin CW Kong DC Tarng et al. (1998) ArticleTitleAnatomical variation of the internal jugular vein and its impact on temporary haemodialysis vascular access: An ultrasonographic survey in uraemic patients Nephrol Dial Transplant 13 134–138 Occurrence Handle10.1093/ndt/13.1.134 Occurrence Handle1:STN:280:DyaK1c7kt1Ohug%3D%3D Occurrence Handle9481729
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Turba, U.C., Uflacker, R., Hannegan, C. et al. Anatomic Relationship of the InternalJugular Vein and the Common Carotid Artery Applied to Percutaneous Transjugular Procedures. Cardiovasc Intervent Radiol 28, 303–306 (2005). https://doi.org/10.1007/s00270-004-0039-z
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DOI: https://doi.org/10.1007/s00270-004-0039-z