Journal Article

Anatomical variation of the internal jugular vein and its impact on temporary haemodialysis vascular access: an ultrasonographic survey in uraemic patients

Bing-Shi Lin, Chi-Woon Kong, Der-Cherng Tarng, Tung-Po Huang and Gau-Jun Tang

in Nephrology Dialysis Transplantation

Volume 13, issue 1, pages 134-138
Published in print January 1998 | ISSN: 0931-0509
Published online January 1998 | e-ISSN: 1460-2385 | DOI: https://dx.doi.org/10.1093/ndt/13.1.134
Anatomical variation of the internal jugular vein and its impact on temporary haemodialysis vascular access: an ultrasonographic survey in uraemic patients

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Background. Creation of a reliable haemoaccess is a critical problem for practicing nephrologists once haemodialysis has been considered. A double-lumen internal jugular-vein catheter is favoured in most cases requiring temporary haemoaccess. However, numerous complications, even lethal ones, may occur with the cannulating procedure. Using ultrasound, we attempted to describe the occult anatomical variations of vessels which may be responsible for complications.

Methods. A ‘SiteRite’ ultrasonographic device was used to inspect the anatomical structure of the internal jugular veins (IJV) in 104 consecutive uraemic patients undergoing creation of internal jugular vein temporary angioaccess. Images of the vessels and demographic data of patients were recorded and analysed.

Results. Anatomical variations of the right and left IJVs were found in 19 (18.3%) and 17 (16.4%) uraemic patients respectively. Unilateral IJV variations were found in 18 patients (17.3%) and bilateral variations were discovered in nine patients (8.7%). A total of 27 patients (26.0%) had IJV anatomical variations that might contribute to difficulty in external landmark-guided IJV cannulation.

Conclusions. The external anatomical landmarks for cannulating the IJV are not reliable in about one-quarter of uraemic patients. An ultrasound survey on the IJV anatomy is recommended for selecting proper puncture site and reducing risks of insertion complications for IJV dialysis catheters.

Keywords: jugular vein; anatomy; uraemia; haemodialysis catheter; vascular access; ultrasonography

Journal Article.  0 words. 

Subjects: Nephrology

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