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The Western Journal of Emergency... Mar 2016Despite multiple advantages, subclavian vein (SCV) cannulation via the traditional landmark approach has become less used in comparison to ultrasound (US) guided... (Review)
Review
Despite multiple advantages, subclavian vein (SCV) cannulation via the traditional landmark approach has become less used in comparison to ultrasound (US) guided internal jugular catheterization due to a higher rate of mechanical complications. A growing body of evidence indicates that SCV catheterization with real-time US guidance can be accomplished safely and efficiently. While several cannulation approaches with real-time US guidance have been described, available literature suggests that the infraclavicular, longitudinal "in-plane" technique may be preferred. This approach allows for direct visualization of needle advancement, which reduces risk of complications and improves successful placement. Infraclavicular SCV cannulation requires simultaneous use of US during needle advancement, but for an inexperienced operator, it is more easily learned compared to the traditional landmark approach. In this article, we review the evidence supporting the use of US guidance for SCV catheterization and discuss technical aspects of the procedure itself.
Topics: Catheterization, Central Venous; Humans; Jugular Veins; Subclavian Vein; Ultrasonography, Interventional
PubMed: 26973755
DOI: 10.5811/westjem.2016.1.29462 -
The Journal of Headache and Pain Sep 2013Migraine is a common neurological disorder of unclear pathogenesis. Recently incompetence of internal jugular vein valve (IJVVI) was found to be associated with some...
BACKGROUND
Migraine is a common neurological disorder of unclear pathogenesis. Recently incompetence of internal jugular vein valve (IJVVI) was found to be associated with some neurological conditions of unknown etiology such as benign cough headache, primary exertional headache or transient global amnesia. Common vascular mechanism linking transiently increased cerebral venous pressure with the above mentioned conditions was then postulated. Therefore we decided to investigate whether IJVVI may be associated with migraine.
AIM AND METHODS
The aim of our study was to evaluate the occurrence of IJVVI and retrograde flow duration in 70 (56 females) migraine patients by color Doppler ultrasound during Valsalva maneuver.We assessed internal jugular vein valve in 44 patients with migraine without aura (39 female); mean age 37 ± 9 yrs. and in 26 patients with migraine with typical aura (17 female); mean age 34 ± 9 yrs. Age- and sex-matched control group consisted of 42 healthy persons (33 female); mean age 32 ± 1 yrs.
RESULTS
Frequency of the internal jugular vein valve insufficiency was similar in patients with migraine and in the healthy subjects (51% v. 40%, p = 0.26). Also mean values of retrograde flow duration were similar in both groups (2.4 ± 0.8 sec in migraine group and 2.2 ± 1.2 sec in controls, p = 0.14).
CONCLUSION
The results of our study show no evidence for an increased prevalence of IJVVI in migraine patients.
Topics: Adult; Cerebrovascular Disorders; Female; Humans; Jugular Veins; Male; Migraine Disorders; Ultrasonography; Venous Valves
PubMed: 24059639
DOI: 10.1186/1129-2377-14-78 -
European Annals of Otorhinolaryngology,... Dec 2011Congenital internal jugular phlebectasia corresponds to congenital dilatation of the vein without tortuosity. More than one hundred cases of phlebectasia involving the...
INTRODUCTION
Congenital internal jugular phlebectasia corresponds to congenital dilatation of the vein without tortuosity. More than one hundred cases of phlebectasia involving the neck veins have been reported in the literature. The authors describe the clinical features, treatment and outcome of this anomaly.
CASE REPORT
A six-year-old child with no particular past medical history presented with a two-year history of progressively enlarging mass on the right side of the neck. Physical examination revealed a non-pulsatile mass that was increased in size by all manoeuvres increasing intrathoracic pressure. Neck computed tomography confirmed the diagnosis of internal jugular vein phlebectasia. In the absence of complications, simple surveillance was advised with a follow-up of 20 months with no complications.
DISCUSSION/CONCLUSION
Congenital internal jugular phlebectasia is a rare condition. Management must include imaging to confirm the diagnosis. Long-term surveillance is recommended and surgery is only required in the presence of complications.
Topics: Child; Dilatation, Pathologic; Humans; Jugular Veins
PubMed: 21596644
DOI: 10.1016/j.anorl.2011.02.008 -
Anaesthesia Mar 2010We investigated the effects of head rotation on the cross-sectional area of the right internal jugular vein and its relative position to the carotid artery. Eighty-eight...
We investigated the effects of head rotation on the cross-sectional area of the right internal jugular vein and its relative position to the carotid artery. Eighty-eight subjects were divided into infants and children groups. The cross-sectional area of the right internal jugular vein and the degree of the carotid artery overlap were measured at 0 degrees (neutral), 40 degrees and 80 degrees of head rotation. The cross-sectional area of the right internal jugular vein was significantly larger at 40 degrees and 80 degrees head rotation compared with the neutral position in both infants and children (p < 0.001). As the head was rotated, the percentage overlap of the carotid artery increased significantly (p < 0.001). We suggest that 40 degrees head rotation appears to be optimal for right internal jugular vein cannulation in paediatric patients.
Topics: Age Factors; Anesthesia, General; Carotid Arteries; Catheterization, Central Venous; Child; Child, Preschool; Female; Head Movements; Humans; Infant; Jugular Veins; Male; Rotation; Ultrasonography
PubMed: 20105152
DOI: 10.1111/j.1365-2044.2009.06209.x -
Journal of Ultrasound Dec 2017To estimate, on the basis of anthropometric and demographic variables, the depth (Dp) and diameter (Dm) of femoral and jugular vessels, which have been located and...
OBJECTIVES
To estimate, on the basis of anthropometric and demographic variables, the depth (Dp) and diameter (Dm) of femoral and jugular vessels, which have been located and measured by ultrasound, in pediatric patients.
METHOD
750 measurements of Dp and Dm of the femoral vein (FV), femoral artery (FA) and internal jugular vein (IJV) were made in 125 pediatric patients. The values were correlated with patients' sex, weight, age, size and body surface area (BSA).
RESULTS
Mean Dp values were 0.72 (0.34) cm for FA, 0.79 (0.35) cm for FV and 0.77 (0.24) cm for IJV. Mean antero-posterior Dm values were 0.37 (0.17) cm for FA, 0.42 (0.22) cm for FV and 0.59 (0.23) cm for IJV. In the studied pediatric patients, femoral and jugular vessels depth correlated with age, size, weight and BSA ( = 0.46-0.60); vascular depth could be estimated from patients' weight and size (FA-Dp: = 0.71; FV-Dp: = 0.72; IJV-Dp: = 0.53). Correlation with diameter was better for FA and FV ( = 0.81-0.89) than for IJV ( = 0.42-0.51); vascular diameter could be estimated from patient's size (FA-Dm: = 0.89; FV-Dm: = 0.86; IJV-Dm: = 0.52).
CONCLUSIONS
FV, FA and IJV depth and diameter correlated with weight, size, age and body surface area in the studied pediatric patients. Correlation was better for femoral than for jugular vessels. Depth could be estimated from patients' weight and size, while diameter could be estimated from the size. Such estimations may facilitate the choice of vessels to be cannulated, length and diameter of cannulation needles and the diameter of catheters to be used in pediatric patients.
Topics: Adolescent; Age Factors; Body Size; Body Surface Area; Child; Child, Preschool; Female; Femoral Vein; Humans; Infant; Infant, Newborn; Jugular Veins; Linear Models; Male; Organ Size; Prospective Studies; Sex Characteristics; Ultrasonography
PubMed: 29204232
DOI: 10.1007/s40477-017-0272-3 -
Journal of Vascular Surgery Jul 2020The porcine arteriovenous graft model is commonly used to study hemodialysis vascular access failure, with most studies using a bilateral, paired-site approach in either...
OBJECTIVE
The porcine arteriovenous graft model is commonly used to study hemodialysis vascular access failure, with most studies using a bilateral, paired-site approach in either the neck or femoral vessels. In humans, left- and right-sided central veins have different anatomy and diameters, and left-sided central vein catheters have worse outcomes. We assessed the effect of laterality on arteriovenous prosthetic graft patency and hypothesized that left-sided carotid-jugular arteriovenous prosthetic grafts have reduced patency in the porcine model.
METHODS
Arteriovenous polytetrafluoroethylene grafts were placed ipsilaterally or bilaterally in 10 Yorkshire male pigs from the common carotid artery to the internal jugular vein. Ultrasound measurements of blood flow velocities and diameters were assessed before graft placement. Animals were sacrificed at 1 week, 2 weeks, or 3 weeks. Patency was determined clinically; grafts and perianastomotic vessels were excised and analyzed with histology and immunostaining.
RESULTS
At baseline, left- and right-sided veins and arteries had similar blood flow velocities. Although internal jugular veins had similar diameters at baseline, left-sided carotid arteries had 11% smaller outer diameters (P = .0354). There were 10 left-sided and 8 right-sided polytetrafluoroethylene grafts placed; only 4 of 10 (40%) grafts were patent on the left compared with 7 of 8 (88%) grafts patent on the right (P = .04). Left-sided grafts had increased macrophages at the arterial anastomosis (P = .0007). Left-sided perianastomotic arteries had thicker walls (0.74 vs 0.60 mm; P = .0211) with increased intima-media area (1.14 vs 0.77 mm; P = .0169) as well as a trend toward 38% smaller luminal diameter (1.6 vs 2.5 mm; P = .0668) and 20% smaller outer diameter (3.0 vs 3.7 mm; P = .0861). Left- and right-sided perianastomotic veins were similar histologically, but left-sided veins had decreased expression of phosphorylated endothelial nitric oxide synthase (P = .0032) and increased numbers of α-actin-positive smooth muscle cells (P = .0022).
CONCLUSIONS
Left-sided arteriovenous grafts are associated with reduced short-term patency compared with right-sided grafts in the Yorkshire pig preclinical model of arteriovenous prosthetic grafts. Laterality must be considered in planning and interpreting surgical preclinical models.
Topics: Animals; Arteriovenous Shunt, Surgical; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Carotid Artery, Common; Graft Occlusion, Vascular; Jugular Veins; Male; Models, Animal; Polytetrafluoroethylene; Prosthesis Design; Risk Factors; Sus scrofa; Time Factors; Vascular Patency
PubMed: 31699515
DOI: 10.1016/j.jvs.2019.06.221 -
BMC Cardiovascular Disorders Mar 2012Accelerated atherosclerosis is the main cause of late aortocoronary vein graft failure. We aimed to develop a large animal model for the study of pathogenesis and...
BACKGROUND
Accelerated atherosclerosis is the main cause of late aortocoronary vein graft failure. We aimed to develop a large animal model for the study of pathogenesis and treatment of vein graft atherosclerosis.
METHODS
An autologous reversed jugular vein graft was inserted end-to-end into the transected common carotid artery of ten hypercholesteroemic minipigs. The vein grafts were investigated 12-14 weeks later with ultrasound and angiograpy in vivo and microscopy post mortem.
RESULTS
One minipig died during follow up (patent vein graft at autopsy), and one vein graft thrombosed early. In the remaining eight patent vein grafts, the mean (standard deviation) intima-media thickness was 712 μm (276 μm) versus 204 μm (74 μm) in the contralateral control internal jugular veins (P < .01). Advanced atherosclerotic plaques were found in three of four oversized vein grafts (diameter of graft > diameter of artery). No plaques were found in four non-oversized vein grafts (P < .05).
CONCLUSIONS
Our model of jugular vein graft in the common carotid artery of hypercholesterolemic minipigs displayed the components of human vein graft disease, i.e. thrombosis, intimal hyperplasia, and atherosclerosis. Advanced atherosclerosis, the main cause of late failure of human aortocoronary vein grafts was only seen in oversized grafts. This finding suggests that oversized vein grafts may have detrimental effects on patient outcome.
Topics: Animals; Atherosclerosis; Carotid Artery, Common; Disease Models, Animal; Follow-Up Studies; Graft Occlusion, Vascular; Humans; Hypercholesterolemia; Jugular Veins; Swine; Swine, Miniature
PubMed: 22463679
DOI: 10.1186/1471-2261-12-24 -
Anaesthesia Mar 1997The relationship between internal jugular vein diameter as measured with an ultrasound imaging machine (SiteRite, Dymax) and external jugular vein diameter was studied...
The relationship between internal jugular vein diameter as measured with an ultrasound imaging machine (SiteRite, Dymax) and external jugular vein diameter was studied in 50 anaesthetised patients undergoing elective cardiac surgery. There was an inverse correlation between external jugular vein diameter and internal jugular vein diameter (r = -0.47, p < 0.001). All patients with an external jugular vein diameter of 7 mm or greater had an internal jugular vein diameter of less than 15 mm. No patient with an external jugular vein diameter of less than 7 mm had an internal jugular vein diameter of less than 20 mm. No other patient dimension (height, weight, body mass index, neck circumference) predicted internal jugular vein size. These results suggest that a large external jugular vein (i.e. 7 mm or greater in external diameter) may be associated with a small internal jugular vein. A size 5.0-mm internal diameter tracheal tube may be used to provide a rapid assessment of external jugular vein diameter.
Topics: Adult; Aged; Anthropometry; Cardiac Surgical Procedures; Cardiopulmonary Bypass; Catheterization, Central Venous; Female; Humans; Jugular Veins; Male; Middle Aged; Ultrasonography
PubMed: 9124661
DOI: 10.1111/j.1365-2044.1997.078-az0076.x -
BMC Veterinary Research Oct 2019Ultrasonography (US) is the recommended imaging technique to evaluate jugular veins. This prospective randomized clinical study was designed to collect a series of...
BACKGROUND
Ultrasonography (US) is the recommended imaging technique to evaluate jugular veins. This prospective randomized clinical study was designed to collect a series of B-mode US measurements of manually distended jugular veins in healthy Italian Standardbreds and to find possible correlations between ultrasound measurements and animal morphometric characteristics. Forty-two horses, eight males and 34 females (range 3-22 years; bodyweight 494.4 ± 41.7 kg), were included in the study. The diameters and wall thicknesses of both jugular veins were measured at three different sites of the neck. The differences in ultrasound measurements based on scans, age, gender, side, and site of the neck were evaluated by ANOVA or by the Kruskal-Wallis test. The effects of the morphometric measures on each ultrasound parameter were evaluated by MANOVA (P < 0.05).
RESULTS
The ultrasound measurements did not differ significantly between the three different sites or between genders; hence, they were pooled together in the results. On the transverse scan, the mean dorsoventral and lateromedial diameters were 1.58 ± 0.23 and 2.20 ± 0.25 cm, respectively; the mean superficial and deep wall thicknesses (SWT and DWT) were 0.07 ± 0.01 and 0.08 ± 0.01 cm, respectively. On the longitudinal scan, the mean dorsoventral diameter was 1.59 ± 0.26 cm, and the SWT and DWT were both 0.08 ± 0.01 cm. Neck length, from the caudal edge of the mandible to the thoracic inlet, was related to the dorsoventral diameter in both longitudinal and transverse scan and to the SWT and DWT in transverse scan, whereas height at the withers (measured with tape) and estimated weight were related to the wall thickness. Dividing the subjects into groups by age in years ("young" 3-7, "mature" 8-14, "old" > 14), differences were found for the lateromedial diameter in the transverse scan and the SWT on the longitudinal scan. The main limitation of this study was that only one operator performed the measurements.
CONCLUSION
The US measurements of the jugular veins and their relationship with morphometric measures reported in this manuscript might be considered as guidelines both for early diagnosis and monitoring jugular vein abnormalities in healthy Italian Standardbred horses.
Topics: Age Factors; Animals; Female; Horses; Jugular Veins; Male; Prospective Studies; Ultrasonography
PubMed: 31619232
DOI: 10.1186/s12917-019-2104-5 -
Experimental Biology and Medicine... Jan 2017To date, no studies have explored the effect of abnormal cerebral venous circulation on brain disorders, whereas many studies have investigated neurodegenerative brain...
To date, no studies have explored the effect of abnormal cerebral venous circulation on brain disorders, whereas many studies have investigated neurodegenerative brain anomalies associated with arterial diseases. The aim of our study was to demonstrate the feasibility of different surgical techniques to induce venous obstruction of cerebral brain drainage. Six C57/black mice underwent bilateral occlusion of the external jugular vein (group EJV), six underwent bilateral occlusion of the internal jugular vein (group IJV), and six underwent bilateral occlusion of both the EJV and the IJV (group EJV/IJV). Within each group, the interruption of blood flow was obtained via monopolar electro-coagulation (ME) in three mice and via surgical ligation (SL) in the remaining three mice. A "sham group" of two mice was used as the control. High-frequency ultrasound (HFUS) was used to detect the absence of blood flow in the examined vessel. The ME procedure led to successful results in two of nine (22%) mice, one in the EJV group, one in the EJV/IJV group, and zero in the IJV group, and 4 of 18 (22%) mice when considering individual veins (i.e., total number of EJVs and IJVs occluded). The SL procedure was successful in two of three (67%) mice in the EJV group, in three of three (100%) mice in the IJV and in three of four (75%) mice in the EJV/IJV group. Therefore, the overall success rate was 8/10 (80%) when considering mice, and 20/26 (77%) when considering individual veins. The monopolar electro-coagulation method exhibited a high mortality due to cardiorespiratory arrest, while the results of the bilateral surgical ligation of EJVs and IJVs show that it is technically feasible and safe.
Topics: Animals; Cerebrovascular Circulation; Cerebrovascular Disorders; Disease Models, Animal; Electrocoagulation; Jugular Veins; Ligation; Mice, Inbred C57BL; Ultrasonography, Doppler, Color
PubMed: 27385594
DOI: 10.1177/1535370216657446