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Internal jugular vein patency following carotid endarterectomy
1Department of Anaesthesia, Royal Perth Hospital, Perth, Western Australia.
Insights
Ultrasound confirmed that internal jugular veins remain open and normally positioned after carotid endarterectomy. This suggests previous carotid surgery is not a contraindication for internal jugular vein cannulation.
Area of Science:
- Vascular Surgery
- Medical Imaging
- Anatomy
Background:
- Carotid endarterectomy is a common surgical procedure.
- Internal jugular vein (IJV) cannulation is frequently used for central venous access.
- Concerns exist regarding IJV patency and position after ipsilateral carotid endarterectomy.
Purpose of the Study:
- To evaluate the patency and anatomical position of the internal jugular vein on the side of previous carotid endarterectomy.
- To determine if prior carotid surgery impacts the suitability of the IJV for cannulation.
Main Methods:
- Ultrasound examinations were performed on 45 patients with a history of carotid endarterectomy.
- Fifty-five internal jugular veins were assessed (including 10 bilateral procedures).
- Assessment focused on the patency and relationship of the IJV to the carotid artery.
Main Results:
- All examined internal jugular veins were found to be patent.
- The internal jugular veins were consistently in a normal anatomical relationship to the carotid artery.
- No adverse findings were noted in relation to prior carotid surgery.
Conclusions:
- Previous carotid endarterectomy does not compromise the patency or normal positioning of the ipsilateral internal jugular vein.
- Internal jugular vein cannulation can be safely considered in patients with a history of carotid surgery.
- The findings support the use of IJV for central access in this patient population.
Abstract:
We performed ultrasound examinations on forty-five patients with a history of carotid endarterectomy to assess the patency and position of the internal jugular vein on the side of the endarterectomy. The study was performed in a tertiary referral centre. In the 55 internal jugular veins examined (ten bilateral procedures), the veins were patent and in a normal relationship to the carotid artery. We concluded that previous carotid surgery should not be a contraindication to cannulation of the internal jugular vein.