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

Objective The objectives of this study were to identify the causes of internal jugular vein (IJV) blood flow reversal revealed on ultrasound imaging. Methods In this retrospective review, 4796 upper extremity venous ultrasounds completed at a single institution between January 2012 and December 2017 were reviewed to identify cases of flow reversal in the IJV. Fourteen patients were identified with IJV flow reversal. Medical charts of these 14 patients were reviewed to identify the etiology of blood flow reversal. Results Intraluminal causes were the most common and were most frequently seen in patients with vascular damage secondary to placement of endovascular devices. Flow reversal most commonly occurred in the left IJV and was equally represented in men and women. Ages ranged from 41.38 to 82.76 years, with an average age of 61.92 years. Conclusion Reversal of flow in the IJV is a rare finding which is most often diagnosed on ultrasound evaluation of the upper extremity. Further investigation should be performed when flow reversal is identified, as the underlying cause may have serious clinical implications.

Download Full-text

Right basilic vein to left external jugular vein venovenous crossover graft against right brachiocephalic vein occlusion in a hemodialysis patient

Nihon Toseki Igakkai Zasshi ◽

10.4009/jsdt.48.735 ◽

2015 ◽

Vol 48 (12) ◽

pp. 735-740

Author(s):

Hideyuki Inoue ◽

Kazuo Kimura ◽

Shinzou Kuzuhara ◽

Yasuko Miura ◽

Shigeru Otubo ◽

...

Keyword(s):

Hemodialysis Patient ◽

Jugular Vein ◽

External Jugular Vein ◽

Brachiocephalic Vein ◽

Basilic Vein ◽

Vein Occlusion

Download Full-text

Ultrasound-guided supraclavicular brachiocephalic vein cannulation versus internal jugular vein cannulation in young children

Research and Opinion in Anesthesia and Intensive Care ◽

10.4103/roaic.roaic_81_18 ◽

2019 ◽

Vol 6 (4) ◽

pp. 455

Author(s):

MofeedA Abdelmaboud

Keyword(s):

Young Children ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Brachiocephalic Vein ◽

Ultrasound Guided ◽

Internal Jugular Vein Cannulation ◽

Vein Cannulation

Download Full-text

Brachiocephalic Vein Perforation During Cannulation of Internal Jugular Vein

A & A Case Reports ◽

10.1213/xaa.0000000000000585 ◽

2017 ◽

Vol 9 (9) ◽

pp. 258-261

Author(s):

Atsushi Kainuma ◽

Keiichi Oshima ◽

Chiho Ota ◽

Yu Okubo ◽

Naoto Fukunaga ◽

...

Keyword(s):

Internal Jugular Vein ◽

Jugular Vein ◽

Brachiocephalic Vein

Download Full-text

The diagnostic value of multi-detector CT angiography for catheter-related central venous stenosis in hemodialysis patients

Phlebology The Journal of Venous Disease ◽

10.1177/0268355520955090 ◽

2020 ◽

pp. 026835552095509

Author(s):

Yuliang Zhao ◽

Letian Yang ◽

Yating Wang ◽

Huawei Zhang ◽

Tianlei Cui ◽

...

Keyword(s):

Internal Jugular Vein ◽

Superior Vena Cava ◽

Subclavian Vein ◽

Jugular Vein ◽

Superior Vena ◽

Vena Cava ◽

Brachiocephalic Vein ◽

Central Venous ◽

Hemodialysis Catheter ◽

Central Venous Stenosis

The objective is to compare Multi-detector CT angiography (MDCTA) and digital subtraction angiography (DSA) in diagnosing hemodialysis catheter related-central venous stenosis (CVS). During a period of 6 years, hemodialysis patients with suspected catheter related-CVS who received both MDCTA and DSA were retrospectively enrolled. We analyzed the sensitivity, specificity, accuracy, Cohen’s kappa coefficient (κ) and other diagnostic parameters for MDCTA compared to DSA. A total of 1533 vascular segments in 219 patients were analyzed. Among the 280 lesions identified by DSA, 156 were correctly identified by MDCTA. There were 124 false negative and 41 false positive diagnoses. MDCTA had a high specificity (96.73%) but a low sensitivity (55.71%), with a moderate inter-test agreement (κ = 0.5930). In stratified analyses of vascular segments, the specificities of MDCTA were 89.93% (superior vena cava), 98.95% (left brachiocephalic vein), 95.33% (right brachiocephalic vein), 99.53% (left subclavian vein), 97.61% (right subclavian vein), 97.13% (left internal jugular vein), and 95.86% (right internal jugular vein), while the sensitivities were 90.00%, 65.52%, 66.67%, 87.50%, 40.00%, 20.00% and 8.11%, respectively. Good to excellent inter-test agreement was observed for the superior vena cava (κ = 0.7870), left brachiocephalic vein (κ = 0.7300), right brachiocephalic vein (κ = 0.6610), and left subclavian vein (κ = 0.8700) compared with poor to low agreement for the right subclavian vein (κ = 0.3950), left internal jugular vein (κ = 0.1890), and right internal jugular vein (κ = 0.0500). MDCTA had a high specificity in diagnosing hemodialysis catheter related-CVS. Its sensitivity varied by central venous segments, with better performance in superior vena cava and brachiocephalic veins.

Download Full-text

Factors Causing Loss of Normal Doppler Waveform of the Left Internal Jugular Vein: Evaluation on Chest Computed Tomography

The Journal of Vascular Access ◽

10.5301/jva.5000750 ◽

2017 ◽

Vol 18 (5) ◽

pp. 402-407 ◽

Cited By ~ 1

Author(s):

Min Cheol Ku ◽

Myung Gyu Song ◽

Tae-Seok Seo ◽

Eun Young Kang ◽

Hwan Seok Yong ◽

...

Keyword(s):

Computed Tomography ◽

Internal Jugular Vein ◽

Doppler Ultrasound ◽

Jugular Vein ◽

Mediastinal Lymph Node ◽

Brachiocephalic Vein ◽

Left Internal Jugular Vein ◽

Access Port ◽

Chest Computed Tomography ◽

Doppler Waveform

Purpose To evaluate the presence and causes of left brachiocephalic vein (LBCV) steno-occlusive lesions in patients with loss of normal waveform in Doppler ultrasound of the left internal jugular vein (LIJV). Materials and Methods We performed Doppler ultrasound of both internal jugular veins in 1912 patients who received an implantable venous access port from August 2013 to January 2016. Among them, 106 patients showed loss of normal Doppler waveforms of the LIJV (56 men and 50 women; mean age, 61.4 ± 11.6 years). We retrospectively analyzed the presence and causes of the LBCV steno-occlusive lesions on contrast-enhanced chest computed tomography (CT) images. Results LBCV steno-occlusive lesions were present in 82 patients (77.4%). The causes of these lesions were anatomic structures (n = 70, 85.4%), tumorous lesions (n = 11, 13.4%), and thrombus (n = 1, 1.2%). The anterior anatomic structures to the LBCV causing stenosis were bony structures (n = 50), right upper lobe (n = 11), and mediastinal fat (n = 9). The posterior anatomic structures to the LBCV resulting in stenosis were right brachiocephalic artery (n = 58), left common carotid artery (n = 7), and aortic arch (n = 5). The tumorous lesions resulting in stenosis were mediastinal lymph node (n = 5), thymic lesions (n = 3), lymphoma (n = 1), lung cancer (n = 1), and bone tumor (n = 1). Conclusions It is necessary to suspect steno-occlusive lesion of the LBCV from various causes and to use caution when performing central venous catheterization in cases with loss of a normal Doppler waveform.

Download Full-text