Clinical significance of the cross-sectional area of the internal jugular vein

Abstract

Objectives: The aim of this study was to compare the cross-sectional area (CSA) of the right internal jugular vein (IJV) with that of the left IJV and to evaluate the anatomic location of the IJV in relation to the common carotid artery, utilizing computed tomography scans of the neck.

Design: Retrospective observational study.

Setting: A tertiary care hospital.

Participants: Eighty patients with neck computed tomography scans scheduled for thyroid surgery.

Intervention: No.

Measurements and main results: Mean CSA of the right and left IJV were 165±81 and 119±57 mm(2), respectively (p<0.01). A relatively larger CSA of the right IJV, compared with that of the left , was seen in 63 (79%) patients. A larger CSA of the right IJV was shown in more right-handed subjects than left-handed subjects (82 v 43%, p<0.05). Small CSA (<50 mm(2)) of the right or left IJV were seen in 4 patients. Both IJVs were located commonly either laterally or anterolaterally to their common carotid arteries. A posterolateral position of the IJV was seen in 4 patients.

Conclusions: This study suggested one advantage of using the right IJV compared with the left for central venous cannulation. However, anatomic variations of the IJV, such as a small CSA and a medial or posterior position, are not associated with demographic data. Although right-handedness was well-correlated with a larger ipsilateral IJV, a possibility of a larger contralateral IJV should be considered. Therefore, central venous cannulation with ultrasonography is recommended to avoid complications and repeated needling.

Keywords: central venous cannulation; cross-sectional area; internal jugular vein; ultrasound.