US-GUIDED PUNCTURE OF THE INTERNAL JUGULAR-VEIN - COMPLICATIONS AND ANATOMIC CONSIDERATIONS

PURPOSE: To examine success and complication rates for ultrasound (US) -guided cannulation of the internal jugular vein (IJV) in comparison w ith blind techniques and to present the variations in anatomy of the I JV. MATERIALS AND METHODS: Data were prospectively collected for 869 c ases of sonographically guided cannulation of the IJV, In all cases, t he side of the puncture, procedural success or failure, and any immedi ate complications were recorded, In 764 (88%) cases, the number of pas ses required and whether a single-or double-wall puncture was used wer e recorded, In 690 (79%) cases, IJV diameter and depth were recorded, while its relationship to the common carotid artery (CCA) was noted in 659 (76%) cases. RESULTS: Cannulation was successful in 868 (99.9%) c ases, Complications occurred in 20 (2.3%) cases, Eighty-seven percent of cannulations were achieved with one pass and 83% with a single-wall puncture, Success at first pass was significantly correlated with rig ht-sided puncture and the diameter of the IJV, In 5.5% of cases, the I JV lay medial to the CCA, making successful cannulation with use of th e landmark technique unlikely. CONCLUSIONS: US-guided cannulation of t he IJV is superior to blind techniques, increasing the success rate an d incidence of first pass cannulation and reducing the incidence of co mplications.