Advanced

Internal jugular dimensions and common carotid overlapping assessed in a cross-sectional study by ultrasonography at three neck levels in healthy volunteers

Norin, Helena; Pikwer, Andreas LU ; Fellert, Fredrik and Åkeson, Jonas LU (2017) In Journal of Vascular Access 18(1). p.69-72
Abstract

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... (More)

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.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cannulation, Central venous catheterization, Common carotid artery, Internal jugular vein, Ultrasound, Vascular anatomy
in
Journal of Vascular Access
volume
18
issue
1
pages
4 pages
publisher
Wichtig Publishing
external identifiers
  • scopus:85010375325
  • pmid:27834452
  • wos:000395837400019
ISSN
1129-7298
DOI
10.5301/jva.5000619
language
English
LU publication?
yes
id
1b8e2a65-f341-4863-80e5-371c5f1edd3b
date added to LUP
2017-02-16 12:08:29
date last changed
2018-01-07 11:50:18
@article{1b8e2a65-f341-4863-80e5-371c5f1edd3b,
  abstract     = {<p>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&lt;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.</p>},
  author       = {Norin, Helena and Pikwer, Andreas and Fellert, Fredrik and Åkeson, Jonas},
  issn         = {1129-7298},
  keyword      = {Cannulation,Central venous catheterization,Common carotid artery,Internal jugular vein,Ultrasound,Vascular anatomy},
  language     = {eng},
  month        = {01},
  number       = {1},
  pages        = {69--72},
  publisher    = {Wichtig Publishing},
  series       = {Journal of Vascular Access},
  title        = {Internal jugular dimensions and common carotid overlapping assessed in a cross-sectional study by ultrasonography at three neck levels in healthy volunteers},
  url          = {http://dx.doi.org/10.5301/jva.5000619},
  volume       = {18},
  year         = {2017},
}