Anatomical variation of the internal jugular vein and its impact on temporary haemodialysis vascular access: an ultrasonographic survey in uraemic patients

Lin, Bing Shi; Kong, Chi Woon; Tarng, Der Cherng; Huang, Tung Po; Tang, Gau Jun

doi:10.1093/ndt/13.1.134

Cited by 121 publications

(81 citation statements)

References 32 publications

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“…It runs parallel to the common carotid artery within the carotid sheath until it joins the subclavian vein deep to the sternal end of the clavicle. The IJVs constitute one of two main pathways for return of intracranial blood (Doepp et al, 2004;Gisolf et al, 2004) and, because of their constancy and relatively superficial position, are frequently used for central venous access by emergency physicians, cardiologists, oncologists, and nephrologists (Denys and Uretsky, 1991;Khatri and Espinosa, 1994;Gadallah et al, 1995;Lin et al, 1998;Work, 2001;O'Dwyer et al, 2005). In addition, the IJVs are important anatomical landmarks for radiologists and surgeons (Müller, 1991;Khatri and Espinosa, 1994;Williams, 1997;Lin et al, 1998;Cormio and Robertson, 2001;Mastronikolis et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Bilateral duplicated internal jugular veins: Case study and literature review

et al. 2006

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A rare bilateral duplication of the internal jugular vein (IJV) was discovered during cadaveric dissection. From each jugular foramen, a single IJV descended to the level of the hyoid bone then divided into medial and lateral veins. The medial IJVs traveled in the carotid sheath; the lateral IJVs coursed posterolateral to the sheath across the lateral cervical region (posterior triangle) of the neck. On the right side, medial and lateral IJVs entered the subclavian vein separately. C2-C3 anterior rami and the suprascapular artery passed between the medial and lateral IJVs. The right external jugular vein passed aberrantly between the heads of the sternocleidomastoid muscle (SCM) into the subclavian vein anterior to the lateral IJV. On the left side, the medial IJV drained into a large bulbous jugulovertebrosubclavian (JVS) sinus that received six main vessels. The lateral IJV diverged posterolaterally toward the border of the trapezius muscle, received the transverse cervical vein, and then turned sharply anteromedially to drain into the JVS sinus. The lateral IJV also gave an aberrant additional large vein that passed laterally around the omohyoid muscle before entering the JVS sinus. The left external jugular vein paralleled the anterior border of SCM before passing posterolaterally to terminate in the JVS sinus. Jugular vein anomalies of this magnitude are very rare. Determining the frequency of multiple IJVs is hampered by inconsistent terminology. We suggest that IJV duplication differs from fenestration anatomically and, potentially, developmentally. Criteria for characterizing IJV duplication and fenestration are proposed. The mechanism of development and the clinical significance of multiple IJVs are discussed.

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Section: Introductionmentioning

confidence: 99%

Bilateral duplicated internal jugular veins: Case study and literature review

et al. 2006

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“…Although the use of real-time ultrasound guidance can reduce the risk of complications during IJV puncture, a deep puncture in the neck could lead to procedure-related complications such as arterial puncture or massive hemorrhage, especially in patients with an anatomic variation or an abnormal deep location of the IJV (29). There were no complications of massive hemorrhage or arterial puncture during EJV catheterization in this study.…”

Section: Discussionmentioning

confidence: 63%

Placement of a Hemodialysis Catheter using the Dilated Right External Jugular Vein as a Primary Route

Park

Shin

2010

J Korean Soc Radiol

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The number of patients with end stage renal disease requiring catheter-based hemodialysis has increased in recent decades. Catheter-based hemodialysis is commonly used during the time it takes for arteriovenous fistula maturation. Conventional venous access sites such as the subclavian vein (SCV) and internal jugular vein (IJV) had been used for catheter placement. However, the SCV should be preserved from catheterization, with consideration of the risk of venous stenosis or thrombosis as complications after a procedure in a patient where fistula or graft creation is planned. The rate of complications for an SCV approach is higher than for an IJV approach. The IJV has become the preferred pri- Results: Technical success was achieved for 41 patients (98%). Catheter placement was unsuccessful in one patient due to narrowing of the EJV. The catheter dwell time ranged between 14 and 305 days (mean; 76 days, total catheter days: 3,111 days). A total of 26 hemodialysis catheters were removed due to complications (n=2) and termination of hemodialysis via the hemodialysis catheter (n=24). There was air embolization (n=1) and catheter kinking (n=3) during procedures and catheter related infections (n=2) during the follow-up period. The incidence of catheter related infection was 0.06 per 100 catheter days. No cases of catheter malfunction or symptomatic venous thrombosis were observed. Conclusion:We suggest that a dilated right EJV could be considered as a preferred primary route for hemodialysis catheter placement with easy access.

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“…The authors did not observe occluded or severely narrowed veins, and even if they did, such an occlusion was very rare (1%-4% of occluded IJVs due to thrombosis after many prior cannulations in critically ill or dialyzed patients). [53][54][55] Similarly, no occluded or severely narrowed IJVs were found in a study that utilized computed tomography. 56 Hypoplastic IJVs (cross-sectional area less than 30 mm 2 ) were either not seen in healthy people 57 or revealed only in a minority (11.1%) of subjects.…”

Section: Results Of Doppler Sonographic Studiesmentioning

confidence: 92%