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Journal of Plastic, Reconstructive &... Jun 2021Free flap failure secondary to internal jugular vein thrombosis (IJVT) is a significant complication after head and neck reconstructive surgery. A consensus has not yet...
BACKGROUND
Free flap failure secondary to internal jugular vein thrombosis (IJVT) is a significant complication after head and neck reconstructive surgery. A consensus has not yet been reached among reconstructive surgeons regarding the treatment of IJVT.
METHODS
We retrospectively evaluated the incidence of IJVT in 118 patients who underwent free flap reconstruction at Hyogo Cancer Center, Akashi, Japan. The occurrence of IJVT-related flap circulation crisis and pulmonary thromboembolism (PTE) was studied. This study was approved by the institutional ethics committee, and written informed consent was obtained from each patient.
RESULTS
From 118 patients who underwent head and neck reconstructive surgery, we included 116 internal jugular veins (IJVs) preserved after neck dissection in the present study. IJVT was confirmed in 25 (21.6%) IJVs from 23 patients. One patient (0.8%) developed venous congestion due to IJVT, which resulted in total flap necrosis. Two patients (1.7%) exhibited PTE associated with IJVT. They were treated with direct oral anticoagulants for 3 months and were discharged without any sequelae.
CONCLUSION
Our results suggest that IJVT after head and neck reconstructive surgery caused not only flap circulation crisis but also PTE. Reconstructive surgeons should be aware of the potential risks due to serious complications associated with IJVT.
Topics: Factor Xa Inhibitors; Female; Free Tissue Flaps; Head and Neck Neoplasms; Humans; Incidence; Japan; Jugular Veins; Male; Middle Aged; Neck Dissection; Outcome and Process Assessment, Health Care; Postoperative Complications; Pulmonary Embolism; Plastic Surgery Procedures; Retrospective Studies; Risk Adjustment; Venous Thrombosis
PubMed: 33288470
DOI: 10.1016/j.bjps.2020.11.007 -
International Journal of Pediatric... Dec 2023Internal jugular vein phlebectasia (IJVP) is a rare type of vascular abnormality that causes dilatation of internal jugular vein in the neck. There is presently no... (Review)
Review
OBJECTIVES
Internal jugular vein phlebectasia (IJVP) is a rare type of vascular abnormality that causes dilatation of internal jugular vein in the neck. There is presently no consensus on the most effective method of treatment for this condition, that is commonly seen in children. We conducted a systematic review of the literature reported till date to comprehend the key features of IJVP and its most effective therapeutic modalities.
METHODS
Five databases were searched until October 10, 2022 for articles of any design (including case reports) reporting IJVP in pediatric subjects. Individual patient data on demographics, clinical features of this entity and the differential diagnosis, methods of imaging, management, and outcome of illness were recorded. The quality assessment was performed using the Joanna Briggs Institute's Critical Appraisal Checklist for studies.
RESULTS
A total of 51 articles including 169 cases were retrieved and included in the analysis. Of the 169 patients, most of them were male children, and in 77% of cases right internal Juglar vein was involved. All patients had some symptoms suggestive of IJVP with most common ones being neck swelling or tenderness, and difficulty in breathing. In 90% of cases, it was observed that the neck swelling typically increases in size with Valsalva maneuver. Once jugular vein phlebectasia was clinically suspected, ultrasonography, CECT, or color Doppler flow imaging were used to confirm the diagnosis. The management of most of the cases was either conservative or surgical, and in surgery mostly ligation was performed. There have not been any cases of serious complications, therefore, according to included studies, a conservative approach is recommended with continuous monitoring. Out of the 51 studies included, most of them had low risk of bias.
CONCLUSION
Internal jugular vein phlebectasia, a rare benign condition, is most commonly found in children, and affects predominantly the right internal jugular vein. Although most patients did well with merely conservative treatment, still management of this vascular anomaly has to be on a case-by-case basis.
Topics: Child; Humans; Male; Female; Jugular Veins; Varicose Veins; Dilatation, Pathologic; Conservative Treatment; Brachiocephalic Veins; Heart Diseases
PubMed: 37871464
DOI: 10.1016/j.ijporl.2023.111720 -
The Journal of Vascular Access Mar 2023To determine the effect of Trendelenburg position on the diameter or cross-section area of the internal jugular vein (IJV) a systematic review and metanalysis was... (Meta-Analysis)
Meta-Analysis
To determine the effect of Trendelenburg position on the diameter or cross-section area of the internal jugular vein (IJV) a systematic review and metanalysis was performed. Studies that evaluated the cross-sectional area (CSA) and anteroposterior (AP) diameter of the right internal jugular vein (RIJV) with ultrasonography in supine and any degree of head-down tilt (Trendelenburg position) were analyzed. A total of 22 articles (613 study subjects) were included. A >5° Trendelenburg position statistically increases RIJV CSA and AP diameter. Further inclination from 10° does not statistically benefit IJV size. This position should be recommended for CVC placement, when patient conditions allow it, and US-guided cannulation is not available.
Topics: Humans; Catheterization, Central Venous; Head-Down Tilt; Jugular Veins; Patient Positioning; Ultrasonography
PubMed: 34254560
DOI: 10.1177/11297298211031339 -
Oral Oncology Oct 2023The internal jugular vein (IJV) provides critical drainage from the brain, skull, and deep regions of the face and neck. Compromise to the bilateral IJVs has severe...
OBJECTIVES
The internal jugular vein (IJV) provides critical drainage from the brain, skull, and deep regions of the face and neck. Compromise to the bilateral IJVs has severe sequelae, but even unilateral IJV sacrifice or thrombosis after treatment can have sequelae. Despite the potential role of IJV reconstruction for head and neck surgeons, information about the indications, technique, and outcomes of the procedure are sparse.
PATIENTS AND METHODS
We present a woman who had IJV sacrifice for an oral cavity cancer along with a contralateral selective neck dissection and adjuvant chemoradiation who developed occlusion of the contralateral IJV after her treatment, resulting in unacceptable cervical lymphedema and extensive neck varicosities. An end-to-side bypass from the superior IJV to the ipsilateral external jugular vein was performed.
RESULTS
There were no complications from the procedure, which resulted in dissipation of her preoperative symptoms. We describe the literature surrounding IJV reconstruction, considerations for its use, the technique itself, and advice for perioperative management.
CONCLUSION
IJV reconstruction is a valuable but underutilized technique for the head and neck microvascular surgeon in cases of bilateral threatened IJV outflow.
Topics: Humans; Female; Jugular Veins; Neck; Neck Dissection; Head; Algorithms
PubMed: 37499330
DOI: 10.1016/j.oraloncology.2023.106523 -
Journal of Neurointerventional Surgery May 2022A small subset of patients with presumed idiopathic intracranial hypertension are found to have isolated internal jugular vein stenosis (IJVS). (Review)
Review
BACKGROUND
A small subset of patients with presumed idiopathic intracranial hypertension are found to have isolated internal jugular vein stenosis (IJVS).
OBJECTIVE
To review the current interventions used in patients who present with intracranial hypertension secondary to IJVS.
METHODS
In December 2020, we performed a literature search on Pubmed/Medline and Scopus databases for original articles studying surgical and endovascular interventions used for intracranial hypertension in the setting of internal jugular vein stenosis. No date, patient population, or study type was excluded.
RESULTS
All studies that included at least one case in which a surgical or endovascular intervention was used to treat IJVS were included. Selection criteria for patients varied, most commonly defined by identification of compression of the internal jugular vein. The 17 studies included in this review ranged from case reports to large single-center cohort studies. The most used surgical intervention was styloidectomy. Styloidectomy had an overall better outcome success rate (79%) than angioplasty/stenting (66%). No complications were recorded in any of the surgical cases analyzed. Outcome measures varied, but all studies recorded clinical symptoms of the patients.
CONCLUSION
Few current large cohort studies analyze surgical and endovascular interventions for patients with IJVS. Notably, the most common intervention is styloidectomy, followed by internal jugular vein stenting. By understanding the trends and experience of interventionalists and surgeons, more focused and larger studies can be performed to determine effective strategies with the best clinical outcomes.
Topics: Constriction, Pathologic; Humans; Intracranial Hypertension; Jugular Veins; Pseudotumor Cerebri; Vascular Diseases
PubMed: 34429346
DOI: 10.1136/neurintsurg-2021-017937 -
Aerospace Medicine and Human Performance Jun 2023Internal jugular vein (IJV) congestion occurs during spaceflight. Historically, IJV distension on the International Space Station (ISS) has been quantified using single...
Internal jugular vein (IJV) congestion occurs during spaceflight. Historically, IJV distension on the International Space Station (ISS) has been quantified using single slice cross-sectional images from conventional 2D ultrasound with remote guidance. Importantly, the IJV is an irregular shape and highly compressible. Consequently, conventional imaging is susceptible to poor reproducibility due to inconsistent positioning, insonation angle, and hold-down pressure, especially when controlled by novice sonographers (i.e., astronauts). Recently, a motorized 3D ultrasound was launched to the ISS that mitigates angulation errors and has a larger design, allowing for more consistent hold-down pressure and positioning. This short communication compares IJV congestion measured with 2D vs. 3D methods during spaceflight. IJV was measured prior to and following a 4-h venoconstrictive thigh cuff countermeasure. Data were acquired from three astronauts approximately halfway through their 6-mo missions. The 2D and 3D ultrasound results were not congruent in all astronauts. 3D ultrasound confirmed that the countermeasure reduced IJV volume in three astronauts by approximately 35%, whereas 2D data were more equivocal. These results indicate that 3D ultrasound provides less error-prone quantitative data. These data are the first to compare 2D and 3D methods during spaceflight in the same participants by using a known countermeasure that reduces IJV congestion. The current results demonstrate that 3D ultrasound should be the preferred imaging method when trying to measure venous congestion in the IJV, and that 2D ultrasound results should be interpreted with caution.
Topics: Humans; Jugular Veins; Reproducibility of Results; Ultrasonography; Space Flight; Astronauts
PubMed: 37194183
DOI: 10.3357/AMHP.6219.2023 -
Cranio : the Journal of... Sep 2023
The association between mandibular position to cervical spine and internal jugular vein diameters in upright position. Have we been ignoring critical generators of head and neck pathology?
Topics: Humans; Jugular Veins; Neck; Head; Cervical Vertebrae
PubMed: 37565696
DOI: 10.1080/08869634.2023.2243756 -
The Journal of Thoracic and... Sep 2022To compare the performance of homografts and bovine jugular vein (BJV) conduits in the pulmonary position.
OBJECTIVE
To compare the performance of homografts and bovine jugular vein (BJV) conduits in the pulmonary position.
METHODS
All patients with congenital heart disease up to age 20 years who underwent pulmonary valve replacement with homografts or BJV at 3 centers in Australia were evaluated. There were 674 conduits, with 305 (45%) pulmonary homografts (PHs), 303 (45%) BJV conduits, and 66 (10%) aortic homografts (AHs). Endpoints were freedom from reintervention, structural valve degeneration (SVD), and infective endocarditis (IE). Propensity score matching was used to balance the comparison of PH and BJV conduits.
RESULTS
The median follow-up was 6.4 years (interquartile range, IQR, 3.1-10.7 years). Freedom from reintervention at 5 and 10 years was 92% and 80%, respectively, for PH, 74% and 37% for BJV, and 75% and 47% for AH. BJV conduits had a higher risk of reintervention (P < .001) and SVD (P < .001) compared with PHs. These findings were confirmed with propensity score matching valid for conduit size >15 mm. AHs >15 mm had a higher risk of reintervention (P < .001) and SVD (P < .001) compared with PHs >15 mm. The performance of AHs and BJV conduits was similar across all sizes (reintervention, P = .94; SVD, P = .72). The incidence of IE was 1% for PH, 10% for BJV, and 1.5% for AH.
CONCLUSIONS
In patients age <20 years with a conduit >15 mm, PHs outperformed BJV conduits and AHs in the pulmonary position. The performance of AH and BJV was comparable. Small conduits (≤15 mm) had similar performance across all conduit types.
Topics: Adult; Allografts; Animals; Bioprosthesis; Cattle; Endocarditis; Endocarditis, Bacterial; Heart Defects, Congenital; Heart Valve Prosthesis; Humans; Infant; Jugular Veins; Retrospective Studies; Treatment Outcome; Young Adult
PubMed: 35058063
DOI: 10.1016/j.jtcvs.2021.11.087 -
Journal of Cardiothoracic and Vascular... Jun 2020THE RISK FACTORS, clinical manifestation, and preventive measures of Horner syndrome (HS) caused by internal jugular vein (IJV) catheterization were explored. Electronic... (Review)
Review
THE RISK FACTORS, clinical manifestation, and preventive measures of Horner syndrome (HS) caused by internal jugular vein (IJV) catheterization were explored. Electronic databases were searched to identify all case reports of HS caused by IJV catheterization. Two authors independently extracted literature characteristics, IJV catheterization method, clinical manifestations, and prognosis data. Twenty case reports (22 patients in total) were included, 18 of which were written in English and the other 2 in Chinese. Patients were between 19 months to 65 years old, and clinical manifestations included ptosis (n = 22), miosis (n = 21), anhidrosis (n = 8), enophthalmos (n = 3), and hoarseness (n = 1). Onset of HS manifestation ranged from a few hours to 19 days after the procedure. Eight patients with ptosis, 6 patients with miosis, and 1 patient with hoarseness recovered during follow-up. Of the 22 patients, 8 underwent more than 1 attempt of IJV catheterization. Six patients experienced accidental carotid artery puncture or hematoma formation during or after IJV catheterization. Ultrasound guidance was applied in 4 patients and anatomic landmark technique was used in the other 18 patients. The left IJV was catheterized in 3 patients, and the right IJV was catheterized in 19 patients. Repeated attempts of puncture, anatomic landmark technique, accidental carotid artery puncture, or hematoma formation may increase the possibility of HS. Ptosis and miosis are the most common manifestations of HS caused by IJV catheterization.
Topics: Carotid Arteries; Catheterization, Central Venous; Horner Syndrome; Humans; Jugular Veins; Ultrasonography
PubMed: 31350153
DOI: 10.1053/j.jvca.2019.06.031 -
BMC Anesthesiology Jun 2022Internal jugular vein catheterization is widely used in clinical practice, and there are many related studies on internal jugular vein catheterization. However, the...
BACKGROUND
Internal jugular vein catheterization is widely used in clinical practice, and there are many related studies on internal jugular vein catheterization. However, the omohyoid muscle, which is adjacent to the internal jugular vein, is a rarely mentioned muscle of the infrahyoid muscles group. The purpose of this study is to explore the anatomical relationship between the omohyoid muscle and the internal jugular vein on ultrasound guidance and provide a theoretical reference for jugular puncture and catheterization.
METHODS
The study included 30 volunteers. The volunteer's head lay in the neutral position and was then turned to the left at an angle of 30°, 45° and 60° with the bed surface, as verified using an adjustable protractor. A high-frequency ultrasound probe (6-14 Hz) was used to examine the plane of the apex of sternocleidomastoid triangle (PAST), the triangle consists of anatomical landmarks: a base was clavicle, its sides - heads of sternocleidomastoid muscle. And the plane of the middle of sternocleidomastoid triangle(PMST) which was a horizontal line, connecting midpoints of both sides. The right omohyoid muscle (OM) and the right internal jugular vein (IJV) were observed and recorded for statistical analysis.
RESULTS
There were statistically significant differences in the number of overlapping cases of OM and IJV at each head rotation angle between the PAST and PMST groups. There were statistically significant differences between the angles which OM and IJV centre point line and the left horizontal position of the PAST and PMST at different body angles.
CONCLUSION
The traditional middle route puncture point is the apex of the sternocleidomastoid triangle, which can effectively avoid injury to the omohyoid muscle, to an extent.
TRAIL REGISTRATION
ChiCTR2000034233 , Registered 29/06/2020. www. Chinese Clinical Trial Registry.gov.
Topics: Catheterization, Central Venous; Head; Humans; Jugular Veins; Muscles; Neck Muscles; Ultrasonography
PubMed: 35698062
DOI: 10.1186/s12871-022-01723-4