Korean J Nephrol.  2010 May;29(3):335-341.

Anatomical Variation of Internal Jugular Vein in Korean Hemodialysis Patients

• Kim HG
• Kim HW
• Yoon SR
• Kim BS
• Song HC
• Kim YS
• Yoon SA
• Kim YS
• Won YD
• Ki YO

Abstract

PURPOSE
The internal jugular vein (IJV) is a preferred site for central cannulation for hemodialysis (HD) because of its low incidence of central vein stenosis. Although anatomically IJV is commonly located on the anterior-lateral side of the carotid artery, some patients have anatomical variation of IJV, which can lead to difficulty and complication of cannulation. This study was performed to evaMETHODS: We enrolled 358 patients receiving IJV catheter cannulation for HD using doppler ultrasonography between January 2007 and February 2009. We examined the anatomical positions of IJV in relation to the position of carotid artery (CA) and incidence of anatomical variation on both sides. We also investigated incidence of inadequate IJV for cannulation,
RESULTS
The mean age of 358 enrolled patients was 57+/-15 years (14-88 years) (M:F=203:155). Anatomical variations of the left (Lt) and right (Rt) IJV position relative to the CA were found in 36.3% and 27.1%, respectively. Various anatomical variations of IJV position were discovered in the anterior side (Lt 23.7%, Rt 21.2%), anterior-medial side (Lt 7%, Rt 2.5%), and the lateral side (Lt 1.1%, Rt 1.7%) relative to CA. Inadequate Lt and Rt IJVs for cannulation, which can be too small sized or obstructed, were 6.4% and 2.8%, respectively.
CONCLUSION
About one third of Korean HD patients had anatomical variations of IJV position relative to the CA. This study supports the use of doppler ultrasound guided technique for IJV cannulation in HD patients.

Keyword

Jugular vein; Carotid artery; Ultrasonography; Hemodialysis

MeSH Terms

Carotid Arteries
Catheterization
Catheters
Constriction, Pathologic
Humans
Incidence
Jugular Veins
Renal Dialysis
Ultrasonography, Doppler
Veins