The influence of head rotation on the anatomical relationship of the right internal jugular vein and the carotid artery

2008 ◽  
Vol 55 (5) ◽  
pp. 538 ◽  
Author(s):  
Soon Im Kim ◽  
Je Hyun Kang ◽  
Young-hee Baek ◽  
Sang Ho Kim ◽  
Si-young Ok ◽  
...  
2015 ◽  
pp. 54-59 ◽  
Author(s):  
Mauricio Umaña Perea ◽  
Alberto Federico García ◽  
José Luis Castillo García ◽  
Luis Alfonso Bustamante Cristancho ◽  
Juan Sebastián Martínez Collazos

Introduction: The internal jugular vein locates anterior or anterolateral to the common carotid artery in two-thirds of the subjects studied by ultrasound when the head is in a rotated position. Aim: To identify variables associated with the anterior location of the internal jugular vein. Methods: Ultrasound examinations were performed with the patients in the supine position, with the head rotated to the opposite side. The proximal third of the neck was visualized transversely with a 7.5-mHz transducer. The relationship between the vessels was described in accordance with the proportion of the artery overlapped by the vein. Univariate comparisons and a multivariate analysis of potential variables that may affect the anatomic relationships were performed. Results: Seventy-eight patients were included, 44 of whom were men. The patients' ages ranged from 17 to 90 years (median 64.0, interquartile range 41-73). The right and left sides were studied 75 and 73 times, respectively. The vein was located lateral to the artery in 24.3% (95%CI= 17.4-32.2) of the studies, anterolateral in 33.8% (95%CI= 26.2-41.4) and anterior in 41.9% (95%CI= 33.9-49.8). The multivariate analysis identified age group (OR= 3.7, 95% CI 2.1-6.4) and, less significantly, the left side (OR= 1.7, 95%CI= 0.8-3.5) and male gender (OR= 1.2, 95%CI= 0.6-2.7) as variables associated with the anterior position of the vein. Conclusión: The anterior position of the internal jugular vein relative to the common carotid artery increases gradually with age. Additionally, left-sided localization and male sex further increased the probability of an anterior position.


2016 ◽  
Vol 18 (1) ◽  
pp. 69-72
Author(s):  
Helena Norin ◽  
Andreas Pikwer ◽  
Fredrik Fellert ◽  
Jonas Åkeson

Background Cannulation of the internal jugular vein may be associated with inadvertent puncture of the common carotid artery. Systematic use of ultrasound guidance has improved clinical success rates and reduced complications, but better knowledge of topographic relationships of the internal jugular vein and common carotid artery is desirable. This preclinical study was designed to determine by ultrasound technique relative topographic characteristics in humans of the internal jugular veins and common carotid arteries at different levels on both sides of the neck. Methods One hundred and twenty healthy volunteers were examined bilaterally by ultrasound at three neck levels with and without contralateral rotation of the head. Twelve digital pictures were recorded and used to determine venous diameters and extents of arteriovenous overlapping in each subject. Results Venous dimensions and arteriovenous overlapping were larger on the right side (p = 0.008) regardless of head rotation at all levels. There was more arteriovenous overlapping with than without rotation at right high- and mid-cervical levels (p<0.001). The only difference between right mid- and low-cervical levels was less arteriovenous overlapping at mid-cervical level without rotation (p = 0.017). The smallest venous dimensions and extent of arteriovenous overlapping were recorded at high-cervical level. Conclusions Despite similar venous dimensions, less arteriovenous overlapping regardless of head rotation at mid-cervical level, together with the pleural proximity at low-cervical level, propose the internal jugular vein to be anatomically (other factors disregarded) favorable for vascular access on the right side, at mid-cervical level, close to the angle between the sternocleidomastoid muscle bellies, and with minimal rotation of the head.


Ultrasound ◽  
2014 ◽  
Vol 22 (2) ◽  
pp. 99-103 ◽  
Author(s):  
Izumi Miki ◽  
Satoru Murata ◽  
Ken Nakazawa ◽  
Shiro Onozawa ◽  
Takahiko Mine ◽  
...  

Renal Failure ◽  
2013 ◽  
Vol 35 (5) ◽  
pp. 761-765 ◽  
Author(s):  
Seda Ozbek ◽  
Seza Apiliogullari ◽  
Ali Sami Kıvrak ◽  
Inci Kara ◽  
Ali Ozgul Saltali

2005 ◽  
Vol 33 (1) ◽  
pp. 82-86 ◽  
Author(s):  
W. Schummer ◽  
C. Schummer ◽  
R. Frober ◽  
J. Fuchs ◽  
M. Simon ◽  
...  

This prospective clinical investigation assessed the effect of placement of a Univent® tube on the anatomy of the internal jugular veins and the success of cannulation of the left internal jugular vein. After obtaining informed consent, 48 adult patients were enrolled. Of these, 42 patients were eligible and were divided into two groups: Univent® tube (group U, n=21) and wire enforced endotracheal tube (group C, n=21). The Univent® tube group were having a left thoracotomy. Using horizontal ultrasound scans just above the thyroid gland, the internal jugular vein was visualized and measured before and after Univent® placement. The number of needle passes necessary to cannulate the left internal jugular vein in the two groups was also compared. Univent® tubes were associated with lateral displacement of the right carotid artery and internal jugular vein on the convex side of the Univent® tube, with compression of the right internal jugular vein by the artery, resulting in a kidney-shaped cross-section of the vein. On the left (concave side of the tube), the neck was indented, the sheath of the left carotid artery was displaced medially, and the left internal jugular vein distorted to an ellipse. There was a significant increase in the lateral diameter and a decrease in the cross-sectional area of the left internal jugular vein (t-test, P<0.05). The first attempt at cannulation of the left internal jugular vein failed significantly more often in the Univent® group (13/21 vs 5/21 in group C, Chi-square 6.22, P=0.025). Cannulation of the internal jugular vein before placement of the Univent® tube, or placement with ultrasound guidance is suggested.


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