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Ultrasound-Guided Retrograde Internal Jugular Venous Puncture in Neurointerventional Procedures.

Jan Mohd Suhail1, Santhosh Babu Kannan Bharathy1, Shikhar Garg1

  • 1Department of Interventional Radiology, Christian Medical College Vellore, Vellore, Tamil Nadu, India.

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|November 30, 2025
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Summary

Ultrasound-guided retrograde internal jugular venous (IJV) puncture is a safe and effective neurointerventional technique. This method demonstrated no major complications in a 20-year retrospective study, suggesting its broad future applicability.

Keywords:
PuncturesThrombosisUltrasoundVeins

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Area of Science:

  • Neurosurgery
  • Vascular Surgery
  • Radiology

Background:

  • Neurointerventional procedures often require venous access for treating complex cerebrovascular diseases.
  • Traditional methods for internal jugular venous (IJV) access can carry risks of complications.
  • Minimally invasive techniques are sought to improve safety and efficacy in vascular access.

Purpose of the Study:

  • To evaluate the safety and efficacy of ultrasound-guided retrograde internal jugular venous (IJV) puncture.
  • To assess the outcomes and complications associated with this specific neurointerventional access technique.

Main Methods:

  • A single-centre retrospective study analyzing 20 years of data.
  • All IJV punctures performed under general anesthesia with ultrasound guidance.
  • Data collected on patient demographics, indications, technique, safety, outcomes, and complications.

Main Results:

  • 74 retrograde IJV punctures in 60 patients (median age 33 years) were analyzed.
  • No inadvertent arterial punctures occurred; the technique achieved expected technical outcomes.
  • Common indications included mechanical thrombectomy for cerebral venous thrombosis (62%) and embolization procedures.

Conclusions:

  • Ultrasound-guided retrograde IJV puncture is a safe and effective method for neurovascular access.
  • The technique has been routinely used without major complications in this cohort.
  • The study anticipates wider adoption of this approach for transvenous neurointerventions.