Assessment of thrombosis in right internal jugular vein after percutaneous superior vena cava catheter insertion during cardiovascular surgery with cardiopulmonary bypass

Abstract

Objective: We evaluated the incidence of percutaneous superior vena cava catheter-related thrombosis and identified risk factors for developing the condition in patients undergoing cardiovascular surgery with cardiopulmonary bypass.

Methods: A total of 121 patients were evaluated. A percutaneous superior vena cava catheter was inserted into the right internal jugular vein during cardiovascular surgery with cardiopulmonary bypass. The right internal jugular vein was evaluated using ultrasonography, including cross-sectional area and velocity just before insertion of the percutaneous superior vena cava catheter (preoperative) and 24 hours and 48 hours after its insertion. If an echogenic mass was detected in the right internal jugular vein, the size was measured.

Results: The incidence of thrombosis in the right internal jugular vein was 56.2%. Change in the right internal jugular vein cross-sectional area and velocity had no clinical implications. Multiple logistic regression analysis identified age (odds ratio, 1.061; 95% confidence interval, 1.022-1.101; P = .002), superior vena cava catheter indwelling duration (odds ratio, 1.015; 95% confidence interval, 1.008-1.023; P < .001), and amount of transfusion platelet concentrate (odds ratio, 1.155; 95% confidence interval, 1.030-1.295; P = .013) as risk factors for percutaneous superior vena cava catheter-related thrombosis in the right internal jugular vein.

Conclusions: The incidence of percutaneous superior vena cava catheter-related thrombosis was higher than conventional central venous catheter-related thrombosis. Risk factors were age, superior vena cava catheter indwelling duration, and amount of transfusion platelet concentrate.

Keywords: central venous catheter; risk prediction; superior vena cava; thrombosis.