Anatomical relationship of the internal jugular vein and the common carotid artery in Korean : A computed tomographic evaluation

ABSTRACT

BACKGROUND: It is important to understand the anatomical relationship of the internal jugular vein (IJV) to the common carotid arteries (CCAs) to avoid inadvertent arterial injury. This study used computed tomography (CT) to evaluate this relationship and the changes associated with simulated 30o body rotation (SR30) in Korean subjects. METHODS: A retrospective analysis of 81 healthy adult subjects was performed using CT during physical checkups between November 2012 and September 2013. Data on both the left and right side IJV and CCA were recorded at the level of the cricoid cartilage and analyzed. The CCA was used as a reference for estimating the IJV location; this was recorded as lateral, anterior, medial, or posterior, using a segmented grid. The degree of overlap was calculated as a percentage, and changes to the anatomic relationship and overlap percentage caused by SR30 were derived. RESULTS: Prior to simulating rotation, the IJV was lateral (54.3%), posterolateral (27.2%), anterolateral (17.9%), or anterior (0.6%) to the CCA. After SR30, their position moved significantly in the anterolateral direction (P = 0.000). The degree of overlap significantly increased from 42.0 to 91.4% after SR30 (P = 0.000). No significant difference was observed between results obtained on the right and left sides before or after SR30. CONCLUSIONS: Special attention should be paid to possible CCA puncture during IJV catheterization because head or body rotation may induce anterior shifting of the IJV location relative to the CCA as well as an increased degree of overlap.