Central venous access via external jugular vein with CT-venography using a Multidetector Helical 16-section CT

Kazuya Kato, Masahiko Taniguchi, Yoshiaki Iwasaki, Keita Sasahara, Atsushi Nagase, Kazuhiko Onodera, Minoru Matsuda, Mineko Higuchi, Miki Nakano, Yuko Kobashi, Hiroyuki Furukawa

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: To determine the success rate and complications of using the external jugular vein (EJV) for central venous access with a preoperative estimate of the detailed anatomical orientation of the cervical venous plexus using computed tomography venography (CT-V). Design: Prospective, observational human study. Setting: Surgical intensive care unit. Patients: Fifty-two patients who were undergoing EJV cannulations with CT-V using a Multidetector Helical 16-section CT (MDCT). Intervention: The preoperative anatomical estimation of the cervical venous plexus was performed with CT-V using an MDCT. In particular, the angulation between the EJV and the right subclavian vein (SCV) was measured. The anatomical abnormalities and the angulation between the EJV and the anterior jugular vein (AJV), transverse cervical vein (TCV), and suprascapular vein (SSV) were estimated. Measurements and Main Results: The success of CT-V was achieved in 52 of 52 patients (100%). The mean angulation between the right EJV and the right SCV was 144 ± 36 degrees in the obtuse-angle cases (88%) and 72 ± 28 degrees in the sharp-angle cases (12%). A plexus of veins under the clavicle was most commonly responsible for insertion of the central venous catheter (CVC). The EJV approach resulted in a 93% rate of successful cannulations. No complications of pneumothorax or carotid artery puncture occurred during insertion procedures. Conclusions: The EJV route is associated with comparable technical success and lower major procedural complication. The EJV approach with CT-V guidance is an option as the initial method when central venous cannulation must be performed under suboptimal conditions.

Original languageEnglish
Pages (from-to)176-182
Number of pages7
JournalJournal of Investigative Surgery
Volume27
Issue number3
DOIs
Publication statusPublished - 2014

Fingerprint

Phlebography
Jugular Veins
Tomography
Cervical Plexus
Catheterization
Subclavian Vein
Veins
Clavicle
Central Venous Catheters
Pneumothorax
Critical Care
Carotid Arteries
Punctures
Observational Studies
Intensive Care Units

Keywords

  • Catheterization
  • Central venous access
  • Cervical venous plexus
  • Computed tomography venography (CT-V)
  • External jugular vein (EJV)
  • Multidetector helical 16-section computed tomography (MDCT)

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

Central venous access via external jugular vein with CT-venography using a Multidetector Helical 16-section CT. / Kato, Kazuya; Taniguchi, Masahiko; Iwasaki, Yoshiaki; Sasahara, Keita; Nagase, Atsushi; Onodera, Kazuhiko; Matsuda, Minoru; Higuchi, Mineko; Nakano, Miki; Kobashi, Yuko; Furukawa, Hiroyuki.

In: Journal of Investigative Surgery, Vol. 27, No. 3, 2014, p. 176-182.

Research output: Contribution to journalArticle

Kato, K, Taniguchi, M, Iwasaki, Y, Sasahara, K, Nagase, A, Onodera, K, Matsuda, M, Higuchi, M, Nakano, M, Kobashi, Y & Furukawa, H 2014, 'Central venous access via external jugular vein with CT-venography using a Multidetector Helical 16-section CT', Journal of Investigative Surgery, vol. 27, no. 3, pp. 176-182. https://doi.org/10.3109/08941939.2013.865818
Kato, Kazuya ; Taniguchi, Masahiko ; Iwasaki, Yoshiaki ; Sasahara, Keita ; Nagase, Atsushi ; Onodera, Kazuhiko ; Matsuda, Minoru ; Higuchi, Mineko ; Nakano, Miki ; Kobashi, Yuko ; Furukawa, Hiroyuki. / Central venous access via external jugular vein with CT-venography using a Multidetector Helical 16-section CT. In: Journal of Investigative Surgery. 2014 ; Vol. 27, No. 3. pp. 176-182.
@article{f4fe4aa2e39e4784a2bf41be7e24bef7,
title = "Central venous access via external jugular vein with CT-venography using a Multidetector Helical 16-section CT",
abstract = "Objective: To determine the success rate and complications of using the external jugular vein (EJV) for central venous access with a preoperative estimate of the detailed anatomical orientation of the cervical venous plexus using computed tomography venography (CT-V). Design: Prospective, observational human study. Setting: Surgical intensive care unit. Patients: Fifty-two patients who were undergoing EJV cannulations with CT-V using a Multidetector Helical 16-section CT (MDCT). Intervention: The preoperative anatomical estimation of the cervical venous plexus was performed with CT-V using an MDCT. In particular, the angulation between the EJV and the right subclavian vein (SCV) was measured. The anatomical abnormalities and the angulation between the EJV and the anterior jugular vein (AJV), transverse cervical vein (TCV), and suprascapular vein (SSV) were estimated. Measurements and Main Results: The success of CT-V was achieved in 52 of 52 patients (100{\%}). The mean angulation between the right EJV and the right SCV was 144 ± 36 degrees in the obtuse-angle cases (88{\%}) and 72 ± 28 degrees in the sharp-angle cases (12{\%}). A plexus of veins under the clavicle was most commonly responsible for insertion of the central venous catheter (CVC). The EJV approach resulted in a 93{\%} rate of successful cannulations. No complications of pneumothorax or carotid artery puncture occurred during insertion procedures. Conclusions: The EJV route is associated with comparable technical success and lower major procedural complication. The EJV approach with CT-V guidance is an option as the initial method when central venous cannulation must be performed under suboptimal conditions.",
keywords = "Catheterization, Central venous access, Cervical venous plexus, Computed tomography venography (CT-V), External jugular vein (EJV), Multidetector helical 16-section computed tomography (MDCT)",
author = "Kazuya Kato and Masahiko Taniguchi and Yoshiaki Iwasaki and Keita Sasahara and Atsushi Nagase and Kazuhiko Onodera and Minoru Matsuda and Mineko Higuchi and Miki Nakano and Yuko Kobashi and Hiroyuki Furukawa",
year = "2014",
doi = "10.3109/08941939.2013.865818",
language = "English",
volume = "27",
pages = "176--182",
journal = "Journal of Investigative Surgery",
issn = "0894-1939",
publisher = "Informa Healthcare",
number = "3",

}

TY - JOUR

T1 - Central venous access via external jugular vein with CT-venography using a Multidetector Helical 16-section CT

AU - Kato, Kazuya

AU - Taniguchi, Masahiko

AU - Iwasaki, Yoshiaki

AU - Sasahara, Keita

AU - Nagase, Atsushi

AU - Onodera, Kazuhiko

AU - Matsuda, Minoru

AU - Higuchi, Mineko

AU - Nakano, Miki

AU - Kobashi, Yuko

AU - Furukawa, Hiroyuki

PY - 2014

Y1 - 2014

N2 - Objective: To determine the success rate and complications of using the external jugular vein (EJV) for central venous access with a preoperative estimate of the detailed anatomical orientation of the cervical venous plexus using computed tomography venography (CT-V). Design: Prospective, observational human study. Setting: Surgical intensive care unit. Patients: Fifty-two patients who were undergoing EJV cannulations with CT-V using a Multidetector Helical 16-section CT (MDCT). Intervention: The preoperative anatomical estimation of the cervical venous plexus was performed with CT-V using an MDCT. In particular, the angulation between the EJV and the right subclavian vein (SCV) was measured. The anatomical abnormalities and the angulation between the EJV and the anterior jugular vein (AJV), transverse cervical vein (TCV), and suprascapular vein (SSV) were estimated. Measurements and Main Results: The success of CT-V was achieved in 52 of 52 patients (100%). The mean angulation between the right EJV and the right SCV was 144 ± 36 degrees in the obtuse-angle cases (88%) and 72 ± 28 degrees in the sharp-angle cases (12%). A plexus of veins under the clavicle was most commonly responsible for insertion of the central venous catheter (CVC). The EJV approach resulted in a 93% rate of successful cannulations. No complications of pneumothorax or carotid artery puncture occurred during insertion procedures. Conclusions: The EJV route is associated with comparable technical success and lower major procedural complication. The EJV approach with CT-V guidance is an option as the initial method when central venous cannulation must be performed under suboptimal conditions.

AB - Objective: To determine the success rate and complications of using the external jugular vein (EJV) for central venous access with a preoperative estimate of the detailed anatomical orientation of the cervical venous plexus using computed tomography venography (CT-V). Design: Prospective, observational human study. Setting: Surgical intensive care unit. Patients: Fifty-two patients who were undergoing EJV cannulations with CT-V using a Multidetector Helical 16-section CT (MDCT). Intervention: The preoperative anatomical estimation of the cervical venous plexus was performed with CT-V using an MDCT. In particular, the angulation between the EJV and the right subclavian vein (SCV) was measured. The anatomical abnormalities and the angulation between the EJV and the anterior jugular vein (AJV), transverse cervical vein (TCV), and suprascapular vein (SSV) were estimated. Measurements and Main Results: The success of CT-V was achieved in 52 of 52 patients (100%). The mean angulation between the right EJV and the right SCV was 144 ± 36 degrees in the obtuse-angle cases (88%) and 72 ± 28 degrees in the sharp-angle cases (12%). A plexus of veins under the clavicle was most commonly responsible for insertion of the central venous catheter (CVC). The EJV approach resulted in a 93% rate of successful cannulations. No complications of pneumothorax or carotid artery puncture occurred during insertion procedures. Conclusions: The EJV route is associated with comparable technical success and lower major procedural complication. The EJV approach with CT-V guidance is an option as the initial method when central venous cannulation must be performed under suboptimal conditions.

KW - Catheterization

KW - Central venous access

KW - Cervical venous plexus

KW - Computed tomography venography (CT-V)

KW - External jugular vein (EJV)

KW - Multidetector helical 16-section computed tomography (MDCT)

UR - http://www.scopus.com/inward/record.url?scp=84899810596&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84899810596&partnerID=8YFLogxK

U2 - 10.3109/08941939.2013.865818

DO - 10.3109/08941939.2013.865818

M3 - Article

C2 - 24354389

AN - SCOPUS:84899810596

VL - 27

SP - 176

EP - 182

JO - Journal of Investigative Surgery

JF - Journal of Investigative Surgery

SN - 0894-1939

IS - 3

ER -