Cerebral venous thrombosis simulating cerebral arterial thrombosis: Late complication of COVID-19?

Context: Brain venous thrombosis (BVT) is uncommon and usually has a different clinic and treatment from cerebral arterial thrombosis. In this context, COVID-19 correlates with thrombogenesis with varied clinical repercussions. This report describes an unusual BVT case as a possible late complication of COVID-19. Case report: Male, 68 years old, athlete and healthy. April/2020: COVID-19 mild symptoms. February/2021: in road-running, he fell due to sudden left hemiparesis. Upon hospital admission: contacting, persistent headache. A week after, low level of consciousness and coma, when underwent right hemicraniectomy. Remains hospitalized. On examination: weak gestural communication, tracheostomy, enteral tube feeding, voluntary blinking. Maintains neutral cervical posture, masticatory automatisms, photoreactive isocoria, generalized rigidity, decorticated right hemiparesis, left hemiplegia. On imaging: hemorrhagic infarction on the right and mass effect due to obstruction of the Basal Rosenthal and Labbé veins and transverse sinus on the right, with venous blood flow in the rest of the hemisphere diverted to the ipsilateral internal jugular vein, by anastomotic veins of the occipital foramen and suboccipital venous plexus. Obstructed left internal jugular vein, with venous collateral flow from the left hemisphere via posterior intercavernous sinus and basilar plexus to the right internal jugular vein. Conclusions: To diagnose the venous etiology that resembled segmental occlusion of the right middle cerebral artery, CT angiography was required. Late evolution of COVID-19 has been identified by the persistence of symptoms for months. Although physical activity and possible dehydration may have contributed to BVT, a prothrombotic state correlated to COVID-19 cannot be discarded.

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B-PO03-215 VENTRICULAR TACHYCARDIA ABLATION DETOUR: ACCESSING THE LEFT VENTRICLE VIA THE RIGHT INTERNAL JUGULAR VEIN DUE TO VASCULAR ANOMALIES

Heart Rhythm ◽

10.1016/j.hrthm.2021.06.688 ◽

2021 ◽

Vol 18 (8) ◽

pp. S277

Author(s):

Ely A. Gracia ◽

Harsha Ganga ◽

Qi Zheng ◽

Cynthia Ennis ◽

Lawrence S. Rosenthal

Keyword(s):

Ventricular Tachycardia ◽

Left Ventricle ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Vascular Anomalies ◽

Ventricular Tachycardia Ablation ◽

The Right

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A Comparison of Outcomes and Complications of Totally Implantable Access Port Through the Internal Jugular Vein Versus the Subclavian Vein

International Surgery ◽

10.9738/intsurg-d-13-00185.1 ◽

2014 ◽

Vol 99 (2) ◽

pp. 182-188 ◽

Cited By ~ 18

Author(s):

Yoshinobu Nagasawa ◽

Tomoharu Shimizu ◽

Hiromichi Sonoda ◽

Eiji Mekata ◽

Masato Wakabayashi ◽

...

Keyword(s):

Internal Jugular Vein ◽

Subclavian Vein ◽

Jugular Vein ◽

Statistical Significance ◽

Late Complication ◽

Insertion Site ◽

Multivariate Logistic Regression Analysis ◽

Late Complications ◽

Complication Rates ◽

Access Port

Abstract Totally implantable access ports (TIAPs) are generally used in oncology. Few studies have addressed complications associated with the insertion site. A total of 233 consecutive oncology patients were enrolled to receive TIAP inserts via internal jugular vein (IJV) or subclavian vein (SV). Data on clinicopathologic parameters and early/late complications were retrospectively collected. No differences were found early and late complication rates. Catheter injury was observed more frequently in the IJV group (2.9%) than in the SV group (1.0%) without statistical significance. Multivariate logistic regression analysis showed that age, switch to palliative use of TIAP, and the distribution of diseases (low risk in patients with colorectal cancer) were independent risk factors for determining complications. In conclusion, TIAP insertion site showed no impact on the early and late complication rates. Catheter injury appears to occur at the same frequency with both approaches. Therefore, medical doctors may choose their preferred puncture site when performing TIAP insertion.

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Folded large-bore central catheter in the right internal jugular vein as shown by ultrasound: a case report

Journal of International Medical Research ◽

10.1177/0300060518813514 ◽

2018 ◽

Vol 47 (2) ◽

pp. 1005-1009

Author(s):

Taehee Pyeon ◽

Jeong-Yeon Hwang ◽

HyungYoun Gong ◽

Sang-Hyun Kwak ◽

Joungmin Kim

Keyword(s):

Central Venous Catheter ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Present Report ◽

Large Diameter ◽

Venous Catheter ◽

Venous Access ◽

Central Venous ◽

The Right ◽

Gain Access

Central venous catheters are used for various purposes in the operating room. Generally, the use of ultrasound to insert a central venous catheter is rapid and minimally complicated. An advanced venous access (AVA) catheter is used to gain access to the pulmonary artery and facilitate fluid resuscitation through the internal jugular vein. The present report describes a case in which ultrasound was used in a 43-year-old man to avoid complications during insertion of an AVA catheter with a relatively large diameter. The sheath of the catheter was so thin that a dilator was essential to prevent it from folding upon insertion. Despite the use of ultrasound guidance, the AVA catheter sheath became folded within the patient’s internal jugular vein. Mechanical complications of central venous catheter insertion are well known, but folding of a large-bore catheter in the internal jugular vein has rarely been reported.

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Aplasia of the superior vena cava and persistent superior left vena cava in a 3-year-old child: Case report

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care ◽

10.17816/psaic940 ◽

2021 ◽

Vol 11 (1) ◽

pp. 85-90

Author(s):

Vladimir V. Lazarev ◽

Tatiana V. Linkova ◽

Pavel M. Negoda ◽

Anastasiya Yu. Shutkova ◽

Sergey V. Gorelikov ◽

...

Keyword(s):

Case Report ◽

Internal Jugular Vein ◽

Superior Vena Cava ◽

Vascular Access ◽

Vascular System ◽

Jugular Vein ◽

Superior Vena ◽

Vena Cava ◽

X Ray ◽

The Right

BACKGROUND: Structural features of the patients vascular system can cause unintended complications when providing vascular access and can disorient the specialist in assessing the location of the installed catheter. This study aimed to demonstrate anatomical features of the vascular system of the superior vena cava and diagnostic steps when providing vascular access in a child. CASE REPORT: Patient K (3 years old) was on planned maintenance of long-term venous access. Preliminary ultrasound examination of the superior vena cava did not reveal any abnormalities. Function of the right internal jugular vein under ultrasound control was performed without technical difficulties; a J-formed guidewire was inserted into the vessel lumen. X-ray control revealed its projection in the left heart, which was regarded as a technical complication, so the conductor was removed. A further attempt to insert a catheter through the right subclavian vein led to the same result. For a more accurate diagnosis, the child underwent computed angiography of the superior vena cava system. Congenital anomalies of the vascular system included aplasia of the superior vena cava and persistent left superior vena cava. Considering the information obtained, the Broviac catheter was implanted under ultrasound control through the left internal jugular vein without technical difficulties with the installation of the distal end of the catheter into the left brachiocephalic vein under X-ray control. CONCLUSION: A thorough multifaceted study of the vascular anatomy helps solve the anatomical issues by ensuring vascular access and preventing the risks of complications.

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Massive hemoptysis following cannulation of right internal jugular vein for insertion of cuffed hemodialysis catheter: A rare complication of central venous catheterization

The Journal of Vascular Access ◽

10.1177/1129729820910304 ◽

2020 ◽

pp. 112972982091030

Author(s):

Hamed Ghoddusi Johari ◽

Mohammad Mehdi Lashkarizadeh ◽

Parviz Mardani ◽

Reza Shahriarirad

Keyword(s):

Internal Jugular Vein ◽

Jugular Vein ◽

Main Bronchus ◽

Rare Complication ◽

Posterior Mediastinum ◽

Chest Roentgenogram ◽

Massive Hemoptysis ◽

Rare Presentation ◽

Hemodialysis Catheter ◽

The Right

Here we report an extremely rare presentation of internal jugular vein catheterization, presenting as massive hemoptysis which was noted during right internal jugular vein cuffed hemodialysis catheter insertion of a 39-year-old man known-case of End-Stage Renal Disease. Chest roentgenogram and computerized tomography scan showed pleural effusion and misplacement of the tip of hemodialysis catheter in the posterior mediastinum causing possible damage to the right main bronchus. After chest tube insertion and removing the misplaced hemodialysis catheter, a proper cuffed catheter was inserted and the patient was discharged with an uneventful post-op course.

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Safely repositioning dual-lumen ECMO cannulas with a transfemoral lasso snare

Perfusion ◽

10.1177/0267659120969031 ◽

2020 ◽

pp. 026765912096903

Author(s):

Erika R O’Neil ◽

Ryan D Coleman ◽

Adam M Vogel ◽

Corey A Chartan ◽

Kamlesh U Kukreja

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Real Time ◽

Internal Jugular Vein ◽

Pediatric Patients ◽

Jugular Vein ◽

Limb Ischemia ◽

Venovenous Extracorporeal Membrane Oxygenation ◽

The Right ◽

Fluoroscopy Guidance ◽

Vv Ecmo

Introduction: Dual-lumen cannulas were designed to provide venovenous extracorporeal membrane oxygenation (VV ECMO) with single-vessel access. Anatomic and size considerations may make appropriate placement challenging in children. Dual-lumen cannulas are repositioned in 20–69% of pediatric patients, which can be difficult without transient discontinuation of ECMO support. Methods: We repositioned three dual-lumen ECMO cannulas introduced via the right internal jugular vein using a transfemoral snare technique under real-time ultrasound and fluoroscopy. Results: Two of three patients were supported on VV ECMO and one on veno-veno-arterial (VV-A) ECMO. Two of the three patients had their dual-lumen cannula repositioned under ultrasound and fluoroscopy guidance and one was repositioned just with ultrasound. No patient experienced a complication from the transfemoral snare technique such as femoral hematoma, hemorrhage or limb ischemia. Conclusion: We describe three patients who successfully had dual-lumen cannulas repositioned without cessation of ECMO using a transfemoral “lasso” technique.

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Variations in the anatomical relationship between the common carotid artery and the internal jugular vein: An ultrasonographic study

Colombia Medica ◽

10.25100/cm.v46i2.1652 ◽

2015 ◽

pp. 54-59 ◽

Cited By ~ 3

Author(s):

Mauricio Umaña Perea ◽

Alberto Federico García ◽

José Luis Castillo García ◽

Luis Alfonso Bustamante Cristancho ◽

Juan Sebastián Martínez Collazos

Keyword(s):

Multivariate Analysis ◽

Carotid Artery ◽

Internal Jugular Vein ◽

Common Carotid Artery ◽

Jugular Vein ◽

Patients Âgés ◽

Anterior Position ◽

Anatomical Relationship ◽

The Common ◽

The Right

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.

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