Anatomical variations of the Internal Jugular Vein in Non-Uremic Outpatients

Abstract

The internal jugular vein (IJV) should be the preferred form of venous vascular access for the placement of dialysis catheters. “Blind” puncture or “skin mark” ultrasound technique puncture present multiple complications due to the significant variations in IJV location in normal subjects and even more so in uremic patients. The aim of this study is to demonstrate the important rate of IJV site variations in a random healthy population. We tested 450 subjects (244 male, 206 female) in our hospital Ultrasound Ambulatory using an Ansaldo AUS ultrasound device with linear 10 MHz probe on both sides at the Sedillot triangle level and noticed the relations between IJV and carotid artery course. The most frequent location of IJV was the anterior lateral (79.3% on the right side, 83.5% on the left). The remaining options were lateral, anterior, posterior-lateral, anterior-medial. We found no significant difference in IJV diameter on either side of the neck. We therefore consider IJV puncture with ultrasound guidance to be the first choice in central venous cannulation for hemodialysis treatment. This procedure helps avoid incorrect puncture of the carotid artery related to its abnormal location.