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The Journal of Vascular Access Nov 2023The purpose is to analyze whether the external jugular vein (EJV) is a feasible and safe alternative access for the retrieval IVCFs designed for the jugular approach.
PURPOSE
The purpose is to analyze whether the external jugular vein (EJV) is a feasible and safe alternative access for the retrieval IVCFs designed for the jugular approach.
METHODS
This study was designed as a nonrandomized, controlled study. The patients were divided into two groups: the IJV or EJV access groups. All operations were performed by the vascular surgery team. The main outcome was the technical success rate. The secondary outcomes included (1) the IVCF retrieval rate; (2) the time required to puncture the access vein (min); (3) the number of punctures required for access, and other aspects.
RESULTS
A total of 119 patients were recruited for IVCF retrieval. Seventeen patients refused to join this trial, leaving 58 patients in the IJV group and 44 patients in the EJV group. In the IJV group, technical success was not achieved in one patient who started in the EJV group and was transferred to the IJV group. There was no significant difference in age, comorbidities, or technical success rate between the two groups. Significant differences were observed in puncture time (min), number of punctures, and inadvertent puncture of the carotid artery. All of the patients were discharged 1 or 2 days after the operation.
CONCLUSION
EJV is safe and feasible alternative access for the retrieval of IVCFs that are designed for jugular approaches.
Topics: Humans; Jugular Veins; Retrospective Studies; Vena Cava Filters; Catheterization, Central Venous; Punctures; Device Removal; Vena Cava, Inferior; Treatment Outcome
PubMed: 35168443
DOI: 10.1177/11297298211064467 -
Journal of Emergency Nursing May 2022Insertion of a peripheral intravenous catheter into the external jugular vein is regularly performed in emergency departments to treat patients with difficult...
Insertion of a peripheral intravenous catheter into the external jugular vein is regularly performed in emergency departments to treat patients with difficult intravenous access. Although emergency nurses are experienced in inserting peripheral intravenous catheters, there is an inconsistent practice and a lack of education and training regarding the insertion of catheters in the external jugular vein. This manuscript provides a practical guide for emergency nurses to care for patients who require an external jugular peripheral intravenous catheter. Key information found in this manuscript includes indications for external jugular intravenous access, the nurse's role in performing external jugular peripheral intravenous catheters, and clinical considerations when caring for patients with an external jugular peripheral intravenous catheter.
Topics: Catheterization, Peripheral; Catheters; Catheters, Indwelling; Humans; Jugular Veins; Nurse's Role
PubMed: 35526875
DOI: 10.1016/j.jen.2022.01.009 -
Anticancer Research May 2020Thrombosis internal jugular vein (IJV) with cervical adenopathy, as first manifestation of gastric cancer is rare. We aimed to compare resection of the cervical mass...
BACKGROUND/AIM
Thrombosis internal jugular vein (IJV) with cervical adenopathy, as first manifestation of gastric cancer is rare. We aimed to compare resection of the cervical mass followed by gastrectomy with gastrectomy alone.
PATIENTS AND METHODS
Nine patients presenting thrombosis of the IJV for gastric carcinoma were divided into two groups. Patients in group A (n=3) underwent anticoagulation treatment, gastrectomy and adjuvant treatment. Patients in group B (n=6) underwent resection of the cervical mass and internal jugular vein (radical neck dissection), and then gastrectomy and adjuvant treatment.
RESULTS
Median survival was 15.3 months in group A (range=11-19 months) and 31.2 months in group B (range=7-44 months) (p=0.11). Late cervical recurrence/complications occurred in 2 patients in group A and none in group B (p=0.02).
CONCLUSION
Resection of thrombosed IJV and satellite lymph nodes, due to a primary gastric cancer may contribute to diagnosis of the disease, limit pulmonary embolic complications and improve quality of life.
Topics: Female; Humans; Jugular Veins; Lymph Nodes; Male; Middle Aged; Stomach Neoplasms; Venous Thrombosis
PubMed: 32366439
DOI: 10.21873/anticanres.14265 -
Vascular Jun 2022Aneurysms of the jugular vein system are rare and high clinical suspicion is needed for diagnosis. External jugular vein aneurysms (EJVA) are considered innocent lesions...
INTRODUCTION
Aneurysms of the jugular vein system are rare and high clinical suspicion is needed for diagnosis. External jugular vein aneurysms (EJVA) are considered innocent lesions that need treatment mainly for aesthetic reasons. The aim of this systematic review was to present current literature regarding diagnosis and management of EJVAs.
METHODS
A literature review was conducted through the Pubmed/Medline and Scopus regarding articles referring on EJVA from 2000 to 2020. Using the PRISMA guidelines (Preferred Reporting Items for Systematic reviews and Meta-Analyses), 30 articles were identified, according to inclusion criteria. Demographics, clinical characteristics, etiology, diagnostic imaging, complications, treatment, and histopathological findings were recorded and analyzed.
RESULTS
Twenty-seven case reports and one case series were identified, including 30 patients and 31 EJVAs. One-third of patients (30.3%) were < 18 years old (mean age 32 years, range 1-72 years) and 54% of them were females. In 51% of the cases, the lesion was characterized as a true aneurysm after histological evaluation. The presence of a soft cervical mass was the most common clinical symptom, while Valsalva maneuver pointed out the presence of an EJVA in 66.7% of patients. Diagnosis was achieved using ultrasonography, computed tomography, or magnetic resonance imaging. Forty-three percent of the patients underwent more than one radiological examination. Twenty patients underwent surgical management. The primary indication of surgical treatment was aesthetic reasons (11/20, 55%). Thrombosis was the most common EJVA complication (11/30, 36.3%).
CONCLUSIONS
Differential diagnosis of neck mass should include EJVA. High clinical suspicion and adequate imaging are important for diagnosis. Open surgical approach is the more commonly applied therapeutic strategy.
Topics: Adolescent; Adult; Aged; Aneurysm; Child; Child, Preschool; Female; Humans; Infant; Jugular Veins; Male; Middle Aged; Subclavian Vein; Thrombosis; Valsalva Maneuver; Young Adult
PubMed: 34024203
DOI: 10.1177/17085381211013950 -
Acta Anaesthesiologica Scandinavica Mar 2021Rapid central venous catheterization is critical for the rescue and perioperative management of premature infants requiring surgery. Ultrasound-guided dynamic needle tip... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Rapid central venous catheterization is critical for the rescue and perioperative management of premature infants requiring surgery. Ultrasound-guided dynamic needle tip positioning (DNTP) has been widely used as a very effective technique, especially in paediatric vascular puncture and catheterization. However, for low-weight premature newborns, central vein catheterization still poses greater difficulties for paediatricians and paediatric anaesthesiologists. This prospective randomized control study aimed to evaluate the efficacy of combined short- and long-axis (CSLA) internal jugular vein catheterization for premature newborns in comparison with the DNTP technique.
METHODS
A total of 90 premature newborns (gestational age < 37 weeks and < 28 days after birth) who were scheduled for surgery were included in this study. All enrolled premature newborns were randomly divided into two groups (n = 45): the CSLA group and the DNTP group. We compared the first-puncture success rate, total success rate, procedure time, number of needle passes, occurrence of complications and other outcome measures between the two groups.
RESULTS
The two groups (n = 45 per group) were similar in sex, gestational age, weight, mean arterial blood pressure, and vein-related measurements of the internal jugular vein. Total success was achieved in 43 (95.6%) and 36 (80.0%) patients in the CSLA and DNTP groups respectively. Compared with the DNTP group, the CSLA group showed a significantly higher first-attempt success rate (71.1% vs 46.7%, χ = 5.5533, P = .0184) and significantly fewer needle passes (1.0[1.0-2.0] vs 2.0[1.0-3.0], χ = -2.6094, P = .0091). There was no significant difference between the groups in the procedure time (368[304-573] vs 478[324-79]s, Z = -1.7690, P = .0769). Complications occurred in both groups, but the incidence was significantly lower in the CSLA group than in the DNTP group (6.7% vs 22.2%, χ = 4.4056, P = .0358).
CONCLUSIONS
Ultrasound-guided internal jugular vein catheterization by the CSLA method is effective and safe. The CSLA method may be superior to the DNTP technique in premature newborns.
Topics: Catheterization, Central Venous; Humans; Infant, Newborn; Infant, Premature; Jugular Veins; Prospective Studies; Ultrasonography; Ultrasonography, Interventional
PubMed: 33147353
DOI: 10.1111/aas.13728 -
Journal of Applied Physiology... Feb 2023Altered gravity affects hemodynamics and blood flow in the neck. At least one incidence of jugular venous thrombosis has been reported in an astronaut on the...
Altered gravity affects hemodynamics and blood flow in the neck. At least one incidence of jugular venous thrombosis has been reported in an astronaut on the International Space Station. This investigation explores the impact of changes in the direction of the gravitational vector on the characteristics of the neck arteries and veins. Twelve subjects underwent graded tilt from 45° head-up to 45° head-down in 15° increments in both supine and prone positions. At each angle, the cross-sectional area of the left and right common carotid arteries (A) and internal jugular veins (A) were measured by ultrasound. Internal jugular venous pressure (IJVP) was also measured by compression sonography. Gravitational dose-response curves were generated from experimental data. A did not show any gravitational dependence. Conversely, both A and IJVP increased in a nonlinear fashion with head-down tilt. A was significantly larger on the right side than the left side at all tilt angles. In addition, IJVP was significantly elevated in the prone position compared with the supine position, most likely because of raised intrathoracic pressure while prone. Dose-response curves were compared with existing experimental data from parabolic flight and spaceflight studies, showing good agreement on an acute timescale. The quantification of jugular hemodynamics as a function of changes in the gravitational vector presented here provides a terrestrial model to reference spaceflight-induced changes, contributes to the assessment of the pathogenesis of spaceflight venous thromboembolism events, and informs the development of countermeasures. Flow stasis and thrombosis have been identified in the jugular vein during spaceflight. We measured the area and pressure of the internal jugular vein and the area of the common carotid artery in graded head-up and head-down tilt. Experimental data are used to generate gravitational dose-response curves for the measured variables, demonstrating that jugular vein area and pressure exhibit a nonlinear response to altered gravity. Gravitational dose-response curves show good agreement with spaceflight and parabolic flight studies.
Topics: Humans; Head-Down Tilt; Space Flight; Hemodynamics; Astronauts; Patient Positioning; Jugular Veins
PubMed: 36476158
DOI: 10.1152/japplphysiol.00248.2022 -
Folia Morphologica 2024The internal jugular veins (IJV) are the primary venous outflow channels of the head and neck. The IJV is of clinical interest since it is often used for central venous... (Review)
Review
The internal jugular veins (IJV) are the primary venous outflow channels of the head and neck. The IJV is of clinical interest since it is often used for central venous access. This literature aims at presenting an overview of the anatomical variations, morphometrics based on various imaging modalities, cadaveric and surgical findings, and the clinical anatomy of IJV cannulation. Additionally, the anatomical basis of complications, techniques to avoid complications, and cannulation in special instances are also included in the review. The review was performed by a detailed literature search and review of relevant articles. A total of 141 articles were included and organized into anatomical variations, morphometrics, and clinical anatomy of IJV cannulation. The IJV is next to important structures such as the arteries, nerve plexus, and pleura, which puts them at risk of injury during cannulation. Anatomical variations such as duplications, fenestrations, agenesis, tributaries, and valves, may lead to an increased failure rate and complications during the procedure, if unnoticed. The morphometrics of IJV, such as the cross-sectional area, diameter, and distance from the skin-to-cavo-atrial junction may assist in choosing the appropriate cannulation techniques and hence reduce the incidence of complications. Age, gender, and side-related differences explained variations in the IJV-common carotid artery relationship, cross-sectional area, and diameter. Accurate knowledge of anatomical variations in special considerations such as paediatrics and obesity may help prevent complications and facilitate successful cannulation.
Topics: Humans; Carotid Artery, Common; Catheterization, Central Venous; Head; Jugular Veins; Neck
PubMed: 36794685
DOI: 10.5603/FM.a2023.0008 -
Radiologic Clinics of North America Jan 2020Central venous catheters (CVCs) are commonly used in patients in a variety of clinical settings, including the intensive care unit, general ward, and outpatient... (Review)
Review
Central venous catheters (CVCs) are commonly used in patients in a variety of clinical settings, including the intensive care unit, general ward, and outpatient settings. After placement, the radiologist is frequently requested to evaluate the location of CVCs and deem them suitable for use. An understanding of the ideal location of catheter tips as well as the approach to identifying malpositioned catheter tips is essential to prevent improper use, recognize and/or prevent further injury, and direct potential lifesaving care. An approach to CVC placement based on tip location can be helpful in localization and guiding management.
Topics: Central Venous Catheters; Humans; Jugular Veins; Medical Errors; Radiography, Thoracic; Subclavian Vein; Tomography, X-Ray Computed
PubMed: 31731895
DOI: 10.1016/j.rcl.2019.08.011 -
Brazilian Journal of Cardiovascular... Aug 2023Homografts and bovine jugular vein are the most commonly used conduits for right ventricular outflow tract reconstruction at the time of primary repair of truncus... (Review)
Review
INTRODUCTION
Homografts and bovine jugular vein are the most commonly used conduits for right ventricular outflow tract reconstruction at the time of primary repair of truncus arteriosus.
METHODS
We reviewed all truncus patients from 1990 to 2020 in two mid-volume centers. Inclusion criteria were primary repair, age under one year, and implantation of either homograft or bovine jugular vein. Kaplan-Meier analysis was used to estimate survival, freedom from reoperation on right ventricular outflow tract, and freedom from right ventricular outflow tract reoperation or catheter intervention.
RESULTS
Seventy-three patients met the inclusion criteria, homografts were implanted in 31, and bovine jugular vein in 42. There was no difference in preoperative characteristics between the two groups. There were 25/73 (34%) early postoperative deaths and no late deaths. Follow-up for survivals was 17.5 (interquartile range 13.5) years for homograft group, and 11.5 (interquartile range 8.5) years for bovine jugular vein group (P=0.002). Freedom from reoperation on right ventricular outflow tract at one, five, and 10 years in the homograft group were 100%, 83%, and 53%; and in bovine jugular vein group, it was 100%, 85%, and 50% (P=0.79). There was no difference in freedom from reoperation or catheter intervention (P=0.32).
CONCLUSION
Bovine jugular vein was equivalent to homografts up to 10 years in terms of survival and freedom from right ventricular outflow tract reoperation or catheter intervention. The choice of either valved conduit did not influence the durability of the right ventricle-pulmonary artery conduit in truncus arteriosus.
Topics: Humans; Animals; Cattle; Infant; Heart Ventricles; Truncus Arteriosus; Jugular Veins; Treatment Outcome; Retrospective Studies; Allografts; Reoperation
PubMed: 37540653
DOI: 10.21470/1678-9741-2022-0341 -
Journal of Clinical Neuroscience :... Apr 2022The incidence and effects of stenosis of the cerebral venous system are poorly understood. When noninvasive computed tomography venography (CTV) of the head and neck...
The incidence and effects of stenosis of the cerebral venous system are poorly understood. When noninvasive computed tomography venography (CTV) of the head and neck suggests complete internal jugular vein (IJV) occlusion, invasive catheter-directed venography can discordantly show venous patency. We compared CTV vs digital subtraction venography (DSV) in the evaluation of patency/occlusion in the suspected IJV and contralateral IJV. We queried the venous intervention database of our U.S. academic tertiary-care hospital to identify patients with complete or near-complete IJV occlusion per CTV from March 1, 2019 to March 1, 2020. We included patients with both noninvasive and invasive imaging of the target segment and the contralateral IJV. Four patients had suspected occlusion of the IJV at the skull base. Invasive catheter-directed venography consisted of DSV to assess direction of flow and vessel caliber, as well as manometry proximal and distal to areas of suspected stenosis. DSV showed patency in all 4 IJVs for which CTV had shown suspected occlusions. CTV findings of the contralateral IJVs were patency (n = 2), moderate stenosis (n = 1), and severe/critical stenosis (n = 1). Contralateral IJV caliber, measured by DSV, was concordant with CTV findings. Median mean-pressure gradients across the apparent occlusion and contralateral segments were 1 (range, 1-4) mmHg and 0 (range, 0-5) mmHg, respectively. Although noninvasive CTV may suggest absence of or attenuated flow within the IJV, this technique may be insufficient to establish complete occlusion. Catheter-directed venography can be used to evaluate patency, vessel caliber, and mean-pressure gradient.
Topics: Catheters; Constriction, Pathologic; Humans; Jugular Veins; Phlebography; Tomography, X-Ray Computed; Vascular Diseases
PubMed: 35114476
DOI: 10.1016/j.jocn.2022.01.024