Right Internal Jugular Vein Is Recommended for Central Venous Catheterization

ABSTRACT

Background: The internal jugular vein (IJV) is one of the recommended sites for safe insertion of a central venous catheter (CVC). Although CVC insertion via the IJV has a lower risk of severe complications such as pneumothorax and arterial bleeding than insertion via the subclavian vein, few reports have provided concrete evidence for the safety of a right-sided approach. Purpose: To examine whether a right-sided approach, rather than a left-sided one is superior for CVC insertion via the IJV. Methods: A retrospective study was performed to compare the right IJV with the left in terms of characteristics such as vertical and horizontal diameters, depth from the skin, and the relationship between the IJV and the common carotid artery (CCA) using the same computed tomography axial slice. Results: From April 2006 to September 2008, 100 patients (50 male and 50 female) who underwent CVC insertion via the IJV before surgery for colorectal cancer were enrolled. Vertical and horizontal diameters of the right IJV were significantly larger than those of the left IJV [right: left (cm), 1.51 ± 0.41 vs 1.13 ± 0.34, p <.0001, 1.54 ± 0.36 vs 1.08 ± 0.33, p <.0001], respectively. The right IJV runs more superficially than the left IJV [right: left (cm), 1.74 ± 0.60 vs 1.87 ± 0.56, p <.0001]. Conclusions: Because the right IJV has a much wider diameter and runs more superficially than the left IJV, a right-sided approach is more acceptable than a left-sided one for CVC insertion via the IJV.

Keywords: :

• central venous catheter
• computed tomography
• internal jugular vein
• IJV-CCA relationship
• right-sided approach
• ultrasound