Unexpected Internal Jugular Vein Obstruction Revealed by Ultrasound Surface Scan Before Central Venous Catheter Insertion

Suzuki, Akihiro; Kunisawa, Takayuki; Sasakawa, Tomoki; Katsumi, Norifumi; Nagashima, Kimimoto; Iwasaki, Hiroshi

doi:10.1213/ane.0b013e3181776bb1

Cited by 8 publications

(2 citation statements)

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“…There are several reports of IJV thrombosis detected by ultrasonography during CVC in patients with thrombotic risk factors [1,2]. However, the patient in this case did not have any preexisting risk factors.…”

Section: Introductionmentioning

confidence: 72%

Internal jugular vein thrombosis associated with venous hypoplasia and protein S deficiency revealed by ultrasonography

Lim

Kim

et al. 2011

J Anesth

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A 41-year-old woman, who had no thrombotic risk factors and past history except congenital scoliosis, underwent central venous catheterization (CVC) before correction of the scoliosis. When internal jugular vein (IJV) catheterization using the anatomical landmark technique failed, CVC under ultrasound guidance was tried. As a consequence, thrombosis and hypoplasia of the right IJV were incidentally detected by ultrasonography. Central venous catheters were then successfully placed in other veins under ultrasound guidance. Also, after examinations to rule out the possibility of pulmonary embolism and to clarify the causes of the IJV thrombosis, the patient was found to have protein S deficiency. CVC under ultrasound guidance should be recommended to prevent the failure of cannulation and complications such as thromboembolism in patients who could possibly have anomalies of vessels as a result of anatomical deformities caused by severe scoliosis, even if patients do not have thrombotic risk factors such as a history of central catheter insertion or intravenous drug abuse, cancer, advanced age, cerebral infarction, and left ventricular dysfunction. Also, if venous thrombosis is found in patients without predisposing risk factors, one should ascertain the cause of the hypercoagulable state, for example protein S deficiency, and perform appropriate treatment and prevention of venous thromboembolism.

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Section: Introductionmentioning

confidence: 72%

Internal jugular vein thrombosis associated with venous hypoplasia and protein S deficiency revealed by ultrasonography

Lim

Kim

et al. 2011

J Anesth

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“…The utilization of US before vein puncture (pre-scan) can provide important anatomical information on the vessels and detect abnormalities such as vein obstructions caused by thrombi [1]. The real-time use of US (US-guided technique) during CVC insertion is known to improve the success rate and reduce the incidence of complications [2].…”

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confidence: 99%

Post-scan: another role of ultrasound in central venous catheter insertion

et al. 2010

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Three-step procedure for safe internal jugular vein catheterization under ultrasound guidance

Tampo

2018

J Med Ultrasonics

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Real-time ultrasound guidance for central venous catheterization has become a standard technique. This technique has been reported to yield high success rates and fewer complications compared with landmark techniques. However, it can be risky when the practitioner does not possess proper knowledge and skills. Lose sight of the needle tip can lead to severe complications such as arterial puncture or pneumothorax. Also, posterior wall penetration of the target vessels must be avoided. Misplacement of the catheter to other vessels can sometimes occur, and may only be discovered after the catheterization procedure. To avoid these complications, we perform a three-step procedure to place an internal jugular vein catheter under ultrasound guidance. The three steps are: (a) advance the needle tip to the internal jugular vein with a short-axis image with an out-of-plane technique, (b) rupture the anterior wall by using a long-axis image with an in-plane technique, and (c) confirm the guidewire position from the internal jugular vein to the brachiocephalic vein using a short-axis image, and a coronal image from the supraclavicular fossa. For safe needle advancement and penetration of the anterior wall of the vein, combined use of short-axis and long-axis images is helpful, and guidewire placement should be confirmed by scanning with the short-axis image and the coronal image.

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Unexpected Internal Jugular Vein Obstruction Revealed by Ultrasound Surface Scan Before Central Venous Catheter Insertion

Cited by 8 publications

References 1 publication

Internal jugular vein thrombosis associated with venous hypoplasia and protein S deficiency revealed by ultrasonography

Internal jugular vein thrombosis associated with venous hypoplasia and protein S deficiency revealed by ultrasonography

Post-scan: another role of ultrasound in central venous catheter insertion

Three-step procedure for safe internal jugular vein catheterization under ultrasound guidance

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