Sharp recanalization of the brachiocephalic vein occlusion through the external jugular vein in hemodialysis patients

AbstractNeck veins are important for various diagnostic, therapeutic and experimental procedures. So knowledge of their anatomical variation is also important. The author reports an unusual site of formation of brachiocephalic vein with multiple venous anomalies in the neck. A rare site of formation of the right brachiocephalic vein was found at the middle of neck under the right sternocleido mastoid muscle by union of right internal jugular and subclavian vein. Another observation was of facial, lingual and superior thyroid veins joined together and formed a common vein over the sternocleidomastoid muscle that drained into the external jugular vein. This unusual course of brachiocephalic vein and aberrant drainage of facial, lingual and superior thyroid veins may cause unusual bleeding during surgeries and invasive procedures. So clinicians should be aware of these variations of major neck veins to avoid complications.

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Upper extremity arteriovenous dialysis fistula causing arterialised blood flow in internal jugular vein in patients with brachiocephalic vein occlusion

Indian Journal of Anaesthesia ◽

10.4103/ija.ija_378_20 ◽

2020 ◽

Vol 64 (10) ◽

pp. 915

Author(s):

Vicko Gluncic ◽

IvanK Lukić ◽

Lara Bonasera ◽

Kenneth Candido

Keyword(s):

Blood Flow ◽

Upper Extremity ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Brachiocephalic Vein ◽

Vein Occlusion ◽

Dialysis Fistula

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Original Research: Feasibility and safety of two surgical techniques for the development of an animal model of jugular vein occlusion

Experimental Biology and Medicine ◽

10.1177/1535370216657446 ◽

2016 ◽

Vol 242 (1) ◽

pp. 22-28 ◽

Cited By ~ 3

Author(s):

Luigi Auletta ◽

Adelaide Greco ◽

Sandra Albanese ◽

Leonardo Meomartino ◽

Marco Salvatore ◽

...

Keyword(s):

Blood Flow ◽

Jugular Vein ◽

Surgical Techniques ◽

External Jugular Vein ◽

Original Research ◽

High Frequency Ultrasound ◽

Surgical Ligation ◽

Venous Circulation ◽

Vein Occlusion ◽

Electro Coagulation

To date, no studies have explored the effect of abnormal cerebral venous circulation on brain disorders, whereas many studies have investigated neurodegenerative brain anomalies associated with arterial diseases. The aim of our study was to demonstrate the feasibility of different surgical techniques to induce venous obstruction of cerebral brain drainage. Six C57/black mice underwent bilateral occlusion of the external jugular vein (group EJV), six underwent bilateral occlusion of the internal jugular vein (group IJV), and six underwent bilateral occlusion of both the EJV and the IJV (group EJV/IJV). Within each group, the interruption of blood flow was obtained via monopolar electro-coagulation (ME) in three mice and via surgical ligation (SL) in the remaining three mice. A “sham group” of two mice was used as the control. High-frequency ultrasound (HFUS) was used to detect the absence of blood flow in the examined vessel. The ME procedure led to successful results in two of nine (22%) mice, one in the EJV group, one in the EJV/IJV group, and zero in the IJV group, and 4 of 18 (22%) mice when considering individual veins (i.e., total number of EJVs and IJVs occluded). The SL procedure was successful in two of three (67%) mice in the EJV group, in three of three (100%) mice in the IJV and in three of four (75%) mice in the EJV/ IJV group. Therefore, the overall success rate was 8/10 (80%) when considering mice, and 20/26 (77%) when considering individual veins. The monopolar electro-coagulation method exhibited a high mortality due to cardiorespiratory arrest, while the results of the bilateral surgical ligation of EJVs and IJVs show that it is technically feasible and safe.

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Internal jugular to internal jugular vein bypass of symptomatic central vein obstruction

The Journal of Vascular Access ◽

10.1177/11297298211070703 ◽

2022 ◽

pp. 112972982110707

Author(s):

Jared Carleton ◽

Jason Chang ◽

Qinghua (Richard) Pu ◽

Robert Rhee

Keyword(s):

Upper Extremity ◽

Jugular Vein ◽

Hemodialysis Patients ◽

Brachiocephalic Vein ◽

Central Vein ◽

Central Venous ◽

Av Fistula ◽

Facial Swelling ◽

Vein Bypass ◽

The Creation

Introduction: Central venous obstruction (CVO) often arises among hemodialysis patients with upper extremity access due to a varying number of risk factors. While the true incidence of CVO in hemodialysis patients is unknown, it been reported in the range of 20%–40% in dialysis patients undergoing venograms. In the non-hemodialysis population, chronic central vein obstruction has a compensatory mechanism comprised of numerous collaterals along the chest wall, neck, and mediastinum. However, the presence of an AVF or AVG ipsilateral to a central venous stenosis or occlusion can overwhelm the collateral network due to the significantly elevated blood flow. This may result in severe and debilitating upper extremity and fascial swelling. While ligation results in almost instantaneous symptomatic relief, it does not address the patient’s underlying pathologic process and necessitates an additional access. As these patients continue to live longer, our strategies to manage these failing accesses are becoming increasingly complex. The goal of preserving existing access while correcting any symptoms is paramount. Previous case reports have documented various surgical options for preserving an existing access. Case presentation: Our patient is a 49-year-old female with hypertension and end-stage renal disease, on hemodialysis through a right arm arteriovenous (AV) fistula. She had a history of multiple AV fistulae creations in the past, all of which previously thrombosed. Several years after the creation of her most recent fistula, she developed severe throbbing headaches, right arm and facial swelling, right eye lacrimation, and blurry vision. AV fistula angiogram demonstrated right brachiocephalic vein chronic occlusion and endovascular revascularization through both trans-AVF and transfemoral approaches were attempted, but unsuccessful. Discussion: This case illustrates the success of the creation of an internal jugular-jugular vein bypass to maintain a right arm arteriovenous fistula, while at the same time, correcting the symptoms of a right brachiocephalic vein occlusion.

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Multiple variations of superficial and deep veins in the neck region of a cadaver: a case report

Anatomy (International Journal of Experimental and Clinical Anatomy) ◽

10.2399/ana.20.753013 ◽

2020 ◽

Vol 14 (2) ◽

pp. 150-155

Author(s):

Nilgün Tuncel Çini ◽

Nazan Güner Sak ◽

Senem Turan Özdemir ◽

İlknur Arı

Keyword(s):

Jugular Vein ◽

Anatomical Variation ◽

Neck Region ◽

External Jugular Vein ◽

Brachiocephalic Vein ◽

Facial Trauma ◽

Common Trunk ◽

Communicating Branch ◽

Male Cadaver ◽

The Right

Multiple variations on the right side of the neck of a 65-year-old male cadaver were observed during a routine dissection. The cadaver had no sign of facial trauma or previous surgery. The facial vein had a communicating branch with the internal jugular vein and distally drained into the jugulo-subclavian confluence via a common trunk with external jugular vein. Other superficial veins of the neck drained into the brachiocephalic vein separately. On the contrary, no anatomical variation was observed on the left side. Even if the variations of the head and neck are common, more than one variation in a single cadaver unilaterally is remarkable. We suggest that it is important for surgeons to examine the patients with ultrasound before any clinical interventions on the neck to determine the possible variations beforehand.

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Development of acquired arteriovenous fistulas in rats due to venous hypertension

Journal of Neurosurgery ◽

10.3171/jns.1994.80.5.0884 ◽

1994 ◽

Vol 80 (5) ◽

pp. 884-889 ◽

Cited By ~ 166

Author(s):

Tomoaki Terada ◽

Randall T. Higashida ◽

Van V. Halbach ◽

Christopher F. Dowd ◽

Mitsuharu Tsuura ◽

...

Keyword(s):

Jugular Vein ◽

Sinus Thrombosis ◽

Venous Hypertension ◽

External Jugular Vein ◽

Dural Sinus ◽

Content Type ◽

Vein Occlusion ◽

Group I ◽

Facial Vein ◽

Fine Print

✓ Dural sinus thrombosis has been hypothesized as a possible cause of dural arteriovenous fistulas (AVF's). The pathogenesis and evolution from thrombosis to actual development of an AVF are still unknown. To study dural fistula formation, a surgically induced venous hypertension model in rats was created by producing an arteriovenous shunt between the carotid artery and the external jugular vein. The external jugular vein beyond the anastomosis was ligated 2 to 3 months after surgery and angiography was performed to identify any new acquired AVF's. Forty-six male Sprague-Dawley rats, each weighing approximately 300 gm, were used for this study. In Group I, 22 rats underwent a common carotid artery anastomosis to the external jugular vein, which is the largest draining vein from the transverse sinus via the posterior facial vein, followed by proximal external jugular vein ligation. In Group II, 13 rats underwent the same surgical procedure, followed by contralateral posterior facial vein occlusion. Group III served as the control group, in which 11 rats underwent only unilateral external jugular vein occlusion with or without contralateral posterior facial vein occlusion. The shunts in Groups I and II were ligated at 2 to 3 months following surgery, and transfemoral angiography was performed immediately before and after occlusion. New acquired AVF's had developed in three rats (13.6%) in Group I, three rats (23.1%) in Group II, and no rats (0%) in Group III. One of these newly formed fistulas was located at the dural sinus, analogous to the human dural AVF. The other five were located in the subcutaneous tissue, including the face and neck. The dural AVF in the rat was present on follow-up angiography at 1 week after the bypass occlusion. It is concluded that chronic venous hypertension of 2 to 3 months' duration, without associated venous or sinus thrombosis, can induce new AVF's affecting the dural sinuses or the subcutaneous tissue.

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APPLICATION OF PERMANENT PACEMAKERS AND OPTIMAL PROGRAMMATION IN HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.3.18 ◽

2018 ◽

pp. 114-121

Author(s):

Van Minh Huynh ◽

Anh Tien Hoang ◽

Khanh Hung Doan ◽

Vu Phong Nguyen ◽

Viet Lam Ngo ◽

...

Keyword(s):

Sick Sinus Syndrome ◽

Clinical Symptoms ◽

Jugular Vein ◽

Pacemaker Implantation ◽

Heart Association ◽

External Jugular Vein ◽

Permanent Pacemaker ◽

Male Gender ◽

Inclusion Criteria ◽

Underlying Diseases

Aim: To evaluate the application of permanent pacemaker and optimal programmation associated with Nora G. checklist in pacemaker implantation. Patients and methods: we analyse the 35 cases who were implanted the permanent pacemakers we analyse the 35 cases who were implanted the permanent pacemakers in 2017. For inclusion criteria, we used the recomendation of ACC/AHA/ HRS and Vietnam Heart Association. Apply the C arm fluoroscopy to perform the implantation of the permanent pacemaker. Most of patients were performed the subclavian vein and cephalic vein as the main way but some cases we choosed the external jugular vein as the alternative route. Results: male gender was 60%, mean age was 71.97±12.55. Mostly cardiac arrhythmia were sick sinus syndrome (42.86%), atrial fibrillation with slow rate response (17.14%), blocAVII nd degree Mobitz II (14.28%), bloc AV III rd (11.42%), the underlying diseases were arterial hypertension 42.86%, coronary disease (20%), diabetes mellitus (14.29%). The implanted pacemekers were predominantly one chamber VVIR type (47.5%). The complications was rare and there were a clear recovery of clinical symptoms and mortality death following the Nora checklist. Conclusion: VT technology is an integral part of the treatment of arrhythmias, especially the optimal combination of programming and the Nora checklist, which makes it more effective. Key words: permanent pacemaker, optimal programmation

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