Anatomical variations in the internal jugular veins of cancer patients affecting central venous access - Anatomical variation of the internal jugularvein

Purpose: Establishing a reliable central venous access is an important proc edure in clinical haematology and oncology. The purpose of this study was t o determine how anatomical variations in the internal jugular vein (IJV) an d its position in relation to the common carotid artery (CCA) in cancer pat ients affects external landmark puncture. Patients and Methods: In 113 pati ents with haematological or oncological diseases we examined sonographicall y potential target regions for placement of a central catheter via the IJV. Results: 36% of our patients showed anatomical variations in the IJV and s urrounding tissue. Conclusions: External landmark puncture may be difficult in a considerable number of patients since the IJV might not be situated i n the presumed location anteriorly or laterally to the CCA, or a normal lum en may not be present in approximately 1/3, of cancer patients. This study supports the use of ultrasound-guided techniques for central venous cathete rs particularly in haematological and oncological patients.