Proper Angle of Sono-guided Central Venous Line Insertion

Area of Science:

• Medical Procedures
• Ultrasound-Guided Interventions
• Vascular Access

Background:

• Central venous catheter (CV line) insertion requires precise technique to minimize complications and maximize success.
• Identifying optimal needle insertion angles for internal jugular vein catheterization is critical for patient safety and procedural efficiency.

Purpose of the Study:

• To determine the ideal needle insertion angles in the sagittal and axial planes for internal jugular vein catheterization.
• To correlate patient head rotation with successful CV line placement.

Main Methods:

• A case series involving patients undergoing right internal jugular vein catheterization under ultrasonography guidance.
• Photographic documentation and AutoCAD 2014 software were used to measure needle angles (axial, sagittal) and head rotation.

Main Results:

• 114 patients (mean age 56.96 years, 68.4% male) were analyzed.
• Common indications included hemodialysis (55.3%) and shock (24.6%).
• Mean needle insertion angles were 102.15° (axial), 36.21° (sagittal), with a mean head rotation of 40.49°.

Conclusions:

• Optimal CV line insertion angles appear to be approximately 102.15° (axial), 36.21° (sagittal), and 40.49° (head rotation).
• These specific angles are associated with satisfactory outcomes in internal jugular vein catheterization.