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

So, Keum Young; Kim, Sang Hun; Kim, Dong Woo

doi:2015.10.2.118

Anesth Pain Med > Volume 10(2); 2015 > Article

Clinical Research

Cardiothoracic and Vascular Anesthesia

Anesthesia and Pain Medicine 2015;10(2):118-123.
DOI: https://doi.org/10.17085/apm.2015.10.2.118 Published online April 30, 2015.

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

Keum Young So, Sang Hun Kim, Dong Woo Kim

¹Department of Anesthesiology and Pain Medicine, Chosun University School of Medicine, Gwangju, Korea. ksh3223@chosun.ac.kr
²Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju, Korea.

Received: 19 December 2014 • Revised: 26 January 2015 • Accepted: 30 January 2015

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.

Key Words: Anatomical relationship, Common carotid artery, Computed tomography, Internal jugular vein, Korean