Anatomical Variations in the Internal Jugular Veins of Cancer Patients Affecting Central Venous Access

Summary

Purpose: Establishing a reliable central venous access is an important procedure in clinical haematology and oncology. The purpose of this study was to determine how anatomical variations in the internal jugular vein (IJV) and its position in relation to the common carotid artery (CCA) in cancer patients affects external landmark puncture. Patients and Methods: In 113 patients with haematological or oncological diseases we examined sonographically potential target regions for placement of a central catheter via the IJV. Results: 36 % of our patients showed anatomical variations in the IJV and surrounding tissue. Conclusions: External landmark puncture may be difficult in a considerable number of patients since the IJV might not be situated in the presumed location anteriorly or laterally to the CCA, or a normal lumen may not be present in approximately ⅓ of cancer patients. This study supports the use of ultrasound-guided techniques for central venous catheters particularly in haematological and oncological patients.

Anatomische Varianten der internen Jugularvenen, die bei Krebspatienten den zentralen Zugang beeinflussen

Studienziel: In der klinischen Hämatologie und Onkologie ist die Anlage eines sicheren zentralen Venenkatheters eine häufig durchzuführende Maßnahme. In dieser Studie wurden die Variationen der Vena jugularis interna sowie deren Lage in Beziehung zur Arteria carotis bei Patienten dieser Krankheitsentitäten untersucht. Patienten und Methode: Wir untersuchten 113 Patienten mit hämatologischen oder onkologischen Erkrankungen sonographisch in dem für einen zentralen Zugang über die Vena jugularis interna typischen Areal. Ergebnisse: 36 % unserer Patienten wiesen Variationen der Vena jugularis interna selbst oder des umgebenden Gewebes auf. Schlussfolgerung: In ca. einem Drittel unserer Patienten konnten solche Veränderungen der Vena jugularis interna diagnostiziert werden, die eine Punktion der Vena ohne gleichzeitige sonographische Steuerung schwierig erscheinen lässt.

Central venous access - Internal jugular vein - Anatomical variations - Cancer patients

Zentraler Venenkatheter - Vena jugularis interna - Variationen - Tumorpatienten

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