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This study evaluates the safety, effectiveness, and feasibility of unguided temporary pacemaker insertion in 348 patients at the Mohamed VI University Hospital of Marrakech. The procedure was performed by cardiology residents and showed a high success rate of 99.71%, with successful access to the right internal jugular vein in 89.66% of cases. The majority of patients (66.38%) achieved venous access on the first attempt, with an average procedure time of 11.5 ± 2.1 minutes. Minor complications were observed in 10.63% of patients, including local hematomas (3.45%), accidental arterial punctures (2.30%), pneumothorax (1.15%), and other issues such as local infections and non-sustained ventricular tachycardia. No deaths attributable to the procedure were reported. The clinical significance of this study lies in its demonstration that unguided temporary pacemaker insertion is a safe and effective alternative in resource-limited settings, reducing treatment delays and potentially lowering mortality among patients requiring temporary cardiac pacing. Based on these results, it is recommended to encourage clinicians in primary and secondary healthcare settings to adopt this approach to improve access to urgent cardiac care in under-resourced regions.
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Transesophageal echocardiography (TEE) has become an essential monitor for the management of most patients undergoing cardiothoracic surgery. TEE and central venous catheter placement are often used during cardiac surgeries. Here we conducted a study comparing TEE 3D probe as a surface probe with the ultrasound?guided (USG) vascular probe for guiding right internal jugular vein (IJV) catheterization. Context: USG vascular probe and TEE probe can help during central venous catheterization (CVC) and can confirm the location of guide wire in the neck vessels. We proposed this study, as there are only few studies comparing between TEE probe as surface probe and USG vascular probe for right IJV cannulation. Aims: To compare the TEE probe as a surface probe and USG vascular probe during right IJV catheterization in cardiac surgeries. Settings and Design: Prospective, comparative study. Methods and Material: One twenty?four patients of either sex posted for major elective cardiac surgery were included in this study. Patients were divided into two groups (TEE group and USG group) of 62 by assigning the study participants alternatively to each group. The goal of this study was to compare the puncture time, visualization of IJV to first successful puncture, quality of the imaging with needle tip positioning, and catheter positioning using both TEE probe and vascular probe. The primary outcome was comparison of time from visualization of the IJV to successful puncture using both TEE probe as a surface probe and vascular probe. Secondary outcome was to compare the quality of image with respect to needle tip positioning and compare quality of image with respect to catheter position using both probes. Statistical Analysis Used: Statistical analyses were performed by using a statistical software package SPSS, version 20.0. Results: The observation and results of our study clearly show the feasibility of TEE as surface probe for guiding central venous catheter in right IJV just like the vascular linear probe. There was no significant difference between the two groups ( P > 0.05). No statistical differences were found in the puncture time, image quality, needle tip positioning, wire positioning, and catheter positioning between the two groups. All the P values were greater than 0.05. Conclusions: The TEE probe can be used as an alternative method to guide IJV puncturing and catheterization when the vascular probe is not available. It is feasible especially in cardiac surgeries where the TEE monitoring machine is a must in modern anesthesia and readily available than an ultrasound machine.
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Se presenta el caso de una paciente de 77 años, en quien, durante una cirugía de resección de tumor cutáneo, se observa incidentalmente aumento de volumen cervical derecho de características dinámicas. El hallazgo corresponde a un aneurisma de la vena yugular interna derecha, diagnóstico de mayor frecuencia en población pediátrica, habitualmente de curso benigno.
A 77-year-old woman in whom, during a skin tumor resection surgery, a right cervical swelling with dynamic characteristics was observed. The finding is compatible with an aneurysm of the right internal jugular vein, more commonly obsered in children, usually with a benign course.
Subject(s)
Humans , Female , Aged , Jugular Veins/diagnostic imaging , Aneurysm/diagnostic imagingABSTRACT
Introduction: The largest paired vein is the internal jugular vein (IJV), which rests laterally adjacent to the main the common carotid artery (CCA) within the carotid triangle at the extremities of the neck. It is the main source of blood flow down from the sigmoid sinus of dural venous sinuses. The obstruction of blood flow or distension of the internal jugular vein can lead to increasing intracranial pressure in the brain and face. The increased the right atrial pressure can be a sign of heart failure, cardiovascular problems, and pulmonary embolism. The aims are to study and note down variations in the course and relations of the internal jugular vein and variations of tributaries of right IJV and left IJV diameter and effects on cardiovascular diseases. Materials and Methods: An observational based cadaveric study was conducted on twenty? four unclaimed embalmed cadavers were dissected from March 2021 to August 2023 in Bidar Institute of Medical Sciences, Bidar, Karnataka, India. Dissection procedure was followed by Cunningham’s manual of practical anatomy volume?3 book. Variations and pattern of bilateral internal jugular veins were observed. Results: External jugular vein access is a highly advantageous location for a heart catheterization. The tributaries of the internal jugular vein form the trunk and overlap on the common carotid artery bifurcation, which leads to adverse effects on baroreceptors and chemoreceptors at the level of divisions of internal and external carotid arteries. The pattern of the right and left internal jugular is quite significant. Conclusion: The study will generate information that would be useful for surgeons, and other clinical physicians and give necessary morphometric data on the internal jugular vein in the South Indian population.
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Objective:To establish the animal model of cervicofacial venous malformations(VMs)by surgical reconstruction of exter-nal jugular vein in sheep.Methods:The external jugular veins of 5 sheep were dissected,and the position,course,branch and exter-nal diameter were observed and measured.The models of VMs with draining and returning veins were constructed by suturing or constric-ting the proximal part of main trunk and ligating or constricting the distal part of the jugular or branch veins.The animal model was eval-uated by Doppler ultrasound,gross observation and histological observation at the 4th week after surgery.Results:The external jugular veins of sheep is in the lateral side of bilateral neck,and the main trunk is formed by the maxillary vein and lingual facial vein.The ex-ternal diameter ranges from 6 to 12 mm,with an average external diameter of 9.3 mm.Immediately after the external jugular vein was sutured and narrowed at the proximal part of the main vein,the distal part of the vein branch was ligated or narrowed,the blood flow speed slowed down and the veins in the model area bulged.4 weeks after surgery,gross observation showed that most veins narrowed and thrombosis was formed in part of the venous lumen.The central region of some specimens was dilated,and the peripheral collateral veins were dilated in some models.Doppler ultrasonography showed that the lumens of most veins were dilated and the returning veins and the inflow veins were narrowed.Colored blood flow was seen in the lumen.Histological observation showed that the structure of vein endothelium and wall was close to the normal vein,and the vein vessel wall of some specimens was thickened.Conclusion:The VMs model estab-lished by external jugular vein of sheep basically meets the re-quirements and is expected to be used in the therapeutic meth-odology research of cervicofacial VMs.
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Abstract The prone position is extensively used to improve oxygenation in patients with severe acute respiratory distress syndrome caused by SARS-CoV-2 pneumonia. Occasionally, these patients exhibit cardiac and respiratory functions so severely compromised they cannot tolerate lying in the supine position, not even for the time required to insert a central venous catheter. The authors describe three cases of successful ultrasound-guided internal jugular vein cannulation in prone position. The alternative approach here described enables greater safety and well-being for the patient, reduces the number of episodes of decompensation, and risk of tracheal extubation and loss of in-situ vascular lines.
Subject(s)
Humans , Catheterization, Central Venous , COVID-19/complications , Prone Position , Ultrasonography, Interventional , COVID-19 , Intensive Care UnitsABSTRACT
Lemierre’s syndrome is characterized by thrombophlebitis of the internal jugular vein with resulting systemic septic emboli. Most cases occur following an oropharyngeal infection and have been historically caused by the bacterial pathogen Fusobacterium necrophorum. However, infection from other pathogens is becoming more common in recent years. Our case is special in the sense that Lemierre’s syndrome was caused by staphylococcus aureus after influenza infection. A 23-month-old male presented with complaints of left neck swelling and recurrent fever for one week, following influenza A infection. The child was ill-appearing with fever, tachycardia, tachypnea, and erythematous swelling on the left cheek. Laboratory results revealed elevated inflammatory markers. Computed tomography (CT) scan of the neck showed loculated fluid collection suggesting an intra parotid abscess with poor visualization of the internal jugular vein (IJV). Blood cultures were positive for methicillin-sensitive Staphylococcus aureus. Due to high clinical suspicion of Lemierre’s syndrome, a doppler ultrasound was obtained which showed a left IJV thrombus. CT scan of the chest after the clinical suspicion showed multiple bilateral pulmonary nodules suggesting septic emboli. He was treated with antibiotics and a six-week course of the anticoagulant with a resolution of his thrombus. Though historically, Lemierre’s disease is caused by Fusobacterium necrophorum, other causative organisms such as methicillin-sensitive Staphylococcus aureus are increasingly being recognized. Lemierre’s disease can present as a complication of influenza. A high index of clinical suspicion based on the location of the abscess helped us delineate diagnostic tests and treatment.
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Objective To investigate the clinical application and safety of DSA-guided infusion port implantation via internal jugular vein,subclavian vein and axillary vein.Methods A total of 827 patients with malignant tumors,who underwent DSA-guided intravenous infusion port implantation at the Jiangyin Municipal People's Hospital of China between March 28,2016 and June 28,2018,were enrolled in this study.According to the used approach in the port implantation,the patients were divided into internal jugular vein group(group A,n=125),subclavian vein group(group B,n=87),and axillary vein group(group C,n=615).The success rate of puncturing and the incidence of complications were compared between each other among the three groups.Results The success rates of the DSA-guided first-time puncturing in group A,B and C were 98.40%(123/125),94.25%(82/87),and 97.89%(602/615)respectively,the difference was statistically significant(P<0.05);the success rate of puncturing in group B was lower than that in group C,and among the other groups there was no statistically significant difference(P>0.05).All patients were followed up for a mean period of(15.56±2.91)months(range of 3-26 months).The overall incidence of postoperative early complications was 3.75%,which in group A was 4.00%(5/125),in group B was 9.20%(8/87),and in group C was 2.93%(18/615),and the incidence of complications in group B was obviously higher than that in group C(P<0.0167).There was no statistically significant difference in the incidence of various complications between each other among the three groups(P>0.05).The overall incidence of postoperative long-term complications was 4.72%(39/827),which in group A was 4.80%,in group B was 14.95%,and in group C was 3.25%,and the incidence of complications in group B was strikingly higher than that in group A and group C,the difference was statistically significant(P<0.05).Comparison of groups for the rates of various complications showed that the incidence of catheter fracture in group B was higher than that in group C,and the clipping syndrome occurred only in group B,the difference was statistically significant(P<0.0167).There was no significant difference in the incidence of other complications between each other among the three groups(P>0.05).The abnormal port-taking rate was 1.45%,including 3 patients in group A,7 patients in group B,and 2 patients in group C.The postoperative abnormal port-taking rate in group B was the highest(8.05%),which was significantly different from that in group C(P<0.0167).Conclusion For intravenous infusion port implantation,axillary vein approach is clinically safe,comfortable,minimally-invasive and highly-efficient method,it is superior to internal jugular vein approach and subclavian vein approach in effectively reducing the incidence of complications and improving the postoperative abnormal port-taking rate of patients.Therefore,this technique can be regarded as a first choice in clinical practice.(J Intervent Radiol,2023,32:1212-1216)
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@#Compared with arteries, the extracranial venous system is characterized by complexity, individual variability and frequent asymmetry, and moreover, it is easily affected by other factors such as respiration, postural change, cardiac function, and surrounding structures. In the past, abnormal development or variation of the extracranial venous system was considered non-pathological and has not been taken seriously; however, an increasing number of evidence has shown that extracranial venous insufficiency does have important pathophysiological consequences in various central nervous system disorders. Several central nervous system disorders are associated with the presence and severity of jugular venous reflux. Chronic cerebrospinal venous insufficiency, as a vascular disease based on comprehensive ultrasound criteria, has aroused the interest in the physiology and pathology of venous reflux. The association between such diseases and central nervous system disorders remains unknown and requires further research. By summarizing current concepts and the latest research findings, this article elaborates on the structural features and physiological function of the extracranial venous system, as well as the potential role of cervical veins in central nervous system disorders.
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White matter hyperintensity (WMH) is one of the major imaging markers of cerebral small vascular disease, which is prevalent in the elderly. At present, the pathogenesis of WMH is not clear, most of the previous studies focused on the arterial system, but the role of the venous system in WMH is attracting more and more attention. Small venous collagen hyperplasia, downstream intracranial venous dilatation and internal jugular venous reflux may be involved in the formation and development of white matter hyperintensity.
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Objective:To explore the value of severe ultrasound measurement of internal jugular vein dilation index (ΔIJV) combined with passive leg raising (PLR) in predicting the volume responsiveness of septic shock.Methods:Patients diagnosed with septic shock under complete mechanical ventilation in the ICU of Jinshan Hospital Affiliated to Fudan University from January 2020 to March 2021 were prospectively selected as the research objects. After 500 mL crystals were injected within 30 min, the patients having the "gold standard" left stroke volume (SV) increased by 15% were allocated to the volume response positive group, and patient having an SV increased by less than 15% to the volume response negative group. First, the maximum anterior posterior diameter (IJV max) and the minimum anterior posterior diameter (IJV min) in the respiratory cycle of internal jugular vein were measured by ultrasound, then SV before and after PLR was measured, and finally SV, IJV max and IJV min were measured again after rapid infusion of 500 mL crystals, and ΔIJV=(IJV max-IJV min)/(IJV mean)×100%. The Wilcoxon rank-sum test was used to compare the hemodynamic indexes before and after capacity expansion and PLR. Spearman rank method was used to analyze the change rate of SV (ΔSV) after PLR and the correlation between ΔIJV and ΔSV of the "gold standard". The sensitivity, specificity and relevant cut-off values were obtained by drawing the subject function curve to evaluate the value of ΔIJV and PLR in predicting the volume responsiveness of patients with sepsis. Results:A total of 56 patients were enrolled in the study, and they were divided into two groups: 32 patients in the volume response positive group and 24 patients in the volume response negative group. There was a positive correlation between ΔIJV and ΔSV after capacity expansion ( r=0.778, P<0.01). Taking ΔIJV>17.3% as the threshold, the area under the curve (AUC) was 0.846 (95% CI: 0.716~0.977), the sensitivity was 84.4% and the specificity was 83.3%. PLR was also positively correlated with ΔSV ( r=0.698, P<0.01). Taking ΔSV>15.5% after PLR as the threshold, the AUC was 0.895 (95% CI: 0.796~0.993), the sensitivity was 96.9%, and the specificity was 79.2%. When ΔIJV combined with PLR predicted volume reactivity, the AUC was 0.944 (95% CI: 0.862~1.000), the sensitivity was 99.8% and the specificity was 87.5%. Conclusions:The measurement of internal jugular vein respiratory dilation index by bedside ultrasound is a reliable index to predict volume responsiveness in patients with sepsis. When combined with PLR, the sensitivity and specificity of prediction can be improved.
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A boy, aged 11 years, was admitted due to intermittent fever for 15 days, cough for 10 days, and "hemoptysis" for 7 days. The boy had fever and cough with left neck pain 15 days ago, and antibiotic treatment was effective. During the course of disease, the boy developed massive "hemoptysis" which caused shock. Fiberoptic bronchoscopy revealed a left pyriform sinus fistula with continuous bleeding. In combination with neck and vascular imaging examination results, the boy was diagnosed with internal jugular vein injury and thrombosis due to congenital pyriform sinus fistula infection and neck abscess. The boy was improved after treatment with temperature-controlled radiofrequency ablation for the closure of pyriform sinus fistula, and no recurrence was observed during the follow-up for one year and six months. No reports of massive hemorrhage and shock due to pyriform sinus fistula infection were found in the searched literature, and this article summarizes the clinical features, diagnosis, and treatment of this boy, so as to provide a reference for the early diagnosis of such disease and the prevention and treatment of its complications.
Subject(s)
Humans , Male , Abscess/surgery , Cough , Fever/complications , Fistula/surgery , Hemoptysis/complications , Neck , ShockABSTRACT
Background:Central venous catheterization is a vital intervention in critically ill patients. The purpose of this study was to compare the procedural parameters and complications associated with anterior and posterior approaches of IJV catheterization under real timeultrasound guidance in critically ill patients. Material And Methods:In this prospective randomised study, 90 patients admitted in various ICUs were randomly allocated two groups of 45 each, including both males and females aged between 18 to 80 years ofage requiring central venous catheterization for various indications. Result:The first attempt success rates were comparable between both the groups. The venous visualization time was 38.52 seconds in Group A and 14.65 seconds in Group P (p<0.001). The venous puncture time and the duration of catheterization was found to be 47.60 sec & 2 minutes in Group A respectively and 24.16 sec & 1 minute 32 sec in Group P respectively (p<0.001). No statistically significant differences were found between the two groups in terms of incidence of carotid arterial puncture, haematoma formation and catheter displacement.Conclusion:It was observed that the posterior approach is better than anterior approach of USG guided IJV catheterization as it improves the accuracy, reduces the access time and duration of catheterization & leads to fewer incidences of immediate complications like carotid arterial puncture & subseque nt haematoma formation.
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The superficial veins are of utmost importanceclinically for cannulation, which is required fordiagnostic purposes and intravenous therapy. One suchsuperficial vein in the neck region is the externaljugular vein. The other vein, deeper in this region, isthe internal jugular vein. The internal jugular vein iscommonly used for central venous catheterization.Anomaly in the course and termination of bothexternal and Internal Jugular Veins (IJV) are critical asthey serve as an important route/site to perform variousdiagnostic or therapeutic procedures. Present caseshows a rare variation of termination of the rightexternal jugular vein into an unusually wider IJV.Variation as described in the present case, if found,would ease the clinicians' task to approach a lessaccessible IJV. Ultrasound-guided venouscatheterization would serve as a guide to perform theprocedure with ease and also to be familiar with suchvariations existing in the venous channels
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Objective To investigate the in vitro and in vivo relative recovery rates of levofloxacin from microdialysis probes. Methods High-performance liquid chromatography (HPLC) was established for determination of levofloxacin concentrations. Column was Kromasil C18 (150 mm×4.6 mm, 5 μm), the mobile phase consisted of acetonitrile and 10 mmol/L of potassium dihydrogen phosphate solution (15:85), with column temperature being 30 °C, detection wavelength being 294 nm, and injection volume being 10 μL. The relative recovery rates of vascular microdialysis probes in vitro were measured by dialysis and reverse dialysis. The effects of drug concentration and flow rate on probe deliveries were investigated. The in vivo recovery rates of the probe in the jugular vein and prostate were measured by reverse dialysis, and the stability of 12 h recovery rate in vivo was investigated. Results When the concentration of levofloxacin was 0.1-50.0 μg/mL, the linear relationship was good in the HPLC analysis (r = 0.998 7), and its specificity was good. The precision and accuracy of high-, medium-, low-concentration quality control samples, and lower limit of quantitation all met the analysis requirements. In the in vitro relative recovery experiments, there was no statistical difference between the recovery rate and reverse recovery rate of the vascular microdialysis probes (P>0.05). Drug concentrations did not affect in vitro recovery rate. The recovery rate decreased with the increase of flow rate. In vivo, the relative recovery rate of the probe was (48.46±1.94)% in the jugular vein and (13.23±1.44)% in the prostate. The relative recovery rates were stable during 12 h. Conclusion The established HPLC can be used for the determination of levofloxacin microdialysis probe. Reverse dialysis can be used to detect the relative recovery rate of levofloxacin microdialysis probe in vivo.
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@#Objective To explore the key points, indications and safety of trans-jugular transcatheter closure of atrial septal defect (ASD) in infants. Methods The clinical data of 53 infants with ASD from January 2017 to May 2019 in our hospital were retrospectively reviewed. There were 20 males and 33 females with the age of 1.2 (0.5-2.9) years, and body weight of 9.0 (6.8-10.6) kg. The ASD diameter was 9.8 (8.0-14.0) mm. Thirty-one patients were treated under the guidance of transesophageal ultrasound (TEE), and the other 22 patients under the guidance of transthoracic echocardiography (TTE). We used the steerable curved sheath through the internal jugular vein under the guidance of echocardiography, and the average occluder size was 13.5±4.5 mm. Results All of the 53 patients were successfully occluded, and none of them changed to radiation-guided or transthoracic surgery. Postoperative hospital stay was 3.35±0.70 d. There was no complication such as peripheral vascular injury, occluder malposition or displacement, serious arrhythmia or pericardial effusion. The patients were followed up for 14.3±5.1 months without arrhythmia, residual shunt, occluder malposition or displacement or thrombus. Conclusion Echocardiography-guided trans-jugular closure of ASD for infants with low weight and large ASD shunt or patients with inferior vena cava abnormalities not suitable for femoral vein treatment, not only overcomes the radiation risk of radiation guidance, but also maintains the advantages of minimal invasiveness and safety, providing a new treatment option for such patients.
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Resumo Traumatismos cervicais penetrantes podem ser potencialmente fatais. Em cerca de 25% dos casos, há lesão vascular associada, que pode evoluir para fístulas arteriovenosas. Os autores apresentam um caso de correção tardia, por cirurgia aberta, de uma fístula carotídeo-jugular e fazem uma breve revisão sobre o diagnóstico e opções de tratamento dessa condição.
Abstract Penetrating neck injuries can be life threatening. In about 25% of cases there are vascular injuries, which can progress to formation of arteriovenous fistulas. The authors present a case of delayed open surgery to repair a carotid-jugular fistula and briefly review the diagnosis and treatment options for this condition.
Subject(s)
Humans , Male , Adult , Wounds, Gunshot , Arteriovenous Fistula/surgery , Carotid Artery Injuries , Jugular Veins/injuries , Vascular Surgical Procedures , Carotid Arteries/surgery , Neck Injuries , Vascular System Injuries , Jugular Veins/surgeryABSTRACT
Aims: A significant incidence of Posterior Vessel Wall Puncture (PVWP) was reported during ultrasound guidance (USG) for internal jugular vein (IJV) catheterization. We studied a new technique of USGIJV cannulation to minimize or avoid PVWP, thereby decreasing overall complication rate, irrespective of the operators' experience level. Materials and Methods: After ethical approval, a prospective study was conducted on adult patients of either gender between 18–65 years of age, belonging to the American Society of Anesthesiologists Physical Status I–III, undergoing general anesthesia and requiring USG-guided IJV cannulation. After induction of general anesthesia and intubation, USG-guided IJV cannulation was done using technique of “proximal pen-holding method” in patients placed in supine position with neck rotated in 15° rotation to the opposite side. The primary outcome was defined as success rate of USG-guided IJV cannulation and incidence of PVWP. The secondary outcome was the incidences of complications such as arterial puncture, adjacent tissue damage, and performer's ease of the procedure (0–10 scale; 0 denoting no ease and extreme difficulty and 10 denoting extreme ease and no difficulty). Results: In 135 patients, right IJV puncture, guidewire, and central line insertion were achieved in single attempt without any PVWP by nine operators which included two anesthesia consultants and seven senior registrars. No complications were reported and ease of procedure were rated as median (interquartile range) of 10 (10). Conclusions: The “proximal pen-holding method” for real-time USG-IJV cannulation helped in avoiding PVWP with lesser complication rate and greater performer's ease.
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Abstract Background and objectives Ultrasound-guided internal jugular vein catheterization is a common and generally safe procedure in the operating room. However, inadvertent puncture of a noncompressible artery such as the subclavian artery, though rare, may be associated with life-threatening sequelae, including hemomediastinum, hemothorax, and pseudoaneurysm. Case report We describe a case of the successful endovascular repair of right subclavian artery injury in a 75-year-old woman. Subclavian artery was injured secondary to ultrasound-guided right internal jugular vein catheterization under general anesthesia for orthopedic surgery. Conclusion Under general anesthesia several factors such as hypotension can mask the signs of subclavian artery injury. This case report indicates that clinicians should be aware of the complications of central venous catheterization and take prompt action.
Resumo Justificativa e objetivos A cateterização da veia jugular interna guiada por ultrassom é um procedimento comum e geralmente seguro em sala cirúrgica. No entanto, a punção inadvertida de uma artéria não compressível, como a artéria subclávia, embora rara, pode estar associada a sequelas e risco para vida, incluindo hemomediastino, hemotórax e pseudoaneurisma. Relato de caso Descrevemos um caso bem-sucedido da correção endovascular de lesão da artéria subclávia direita em uma paciente de 75 anos. A artéria subclávia foi lesionada após cateterização guiada por ultrassom da veia jugular interna direita sob anestesia geral para cirurgia ortopédica. Conclusão Sob anestesia geral, vários fatores, como a hipotensão, podem mascarar os sinais de lesão da artéria subclávia. Este relato de caso indica que os médicos devem estar cientes das complicações da cateterização venosa central e tomar medidas imediatas.
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Humans , Female , Aged , Subclavian Artery/injuries , Catheterization, Central Venous/adverse effects , Vascular System Injuries/etiology , Endovascular Procedures/methods , Catheterization, Central Venous/methods , Ultrasonography, Interventional/methods , Orthopedic Procedures/methods , Jugular Veins/diagnostic imagingABSTRACT
Background: Jugular foramen, a large irregular foramen at the base of the skull , lies at the posterior end of petrooccipital suture between jugular process of occipital bone and jugular fossa of petrous part of temporal bone;above and lateral to foramen magnum. Many important structures pass through this foramen. Among these areInferior Petrosal Sinus, presence of three cranial nerves 9, 10, and 11 and Internal Jugular vein.The increasinguse of modern diagnostic procedures and new surgical approaches has created a need for much more detailedanatomical studies and explanations.Materials and Methods: The study was conducted in Osteology lab of Anatomy Department,KarpagaVinayagaInstitute of Medical Sciences, Chinnakolambakkam,Madurntakam taluk,Tamilnadu (India). 66 jugular foraminaof 33 Adult human skulls have been examined for study.Results and Conclusion: The morphometric and morphological analysis of jugular foramen were done in 33skulls, and the results obtained are mentioned below. The Mean average width of foramen is 15.26mm and theRange is between 10mm and 21mm. The Mean average length of foramen is 10mm and the Range is between 6mmand 14mm.Regarding, the size of the foramina; the Right side is larger than the Left side. Incomplete Intrajugularprocess is the commonest observation observed (in 64 foramina).Regarding,Intra Jugular Process contributionfor foramen, it is mainly from Temporal bone. Separate foramen for IPS was found only in one foramen out of 66foramina observed.The height of dome of jugular fossa is more on the Right than on the Left side (in 60.6% ofskulls).The range of Height of the Dome is 6.41mm to 18.46mm and the Mean average is 12.11mm.