Ultrasound Analysis of the Anatomical Relationships between Vertebral Arteries and Internal Jugular Veins in Adults
Uno, A.; Tanaka, S.; Kanno, M.; Ishioka, Y.; Watanabe, M.; Yamakage, M.
Masui. Japanese Journal of Anesthesiology 64(4): 383-387
2015
ISSN/ISBN: 0021-4892 PMID: 26419100 Document Number: 679469
Accidental puncture of a vertebral artery can occur through the internal jugular vein during central venous catheterization. We evaluated the anatomical relationships between vertebral arteries and internal jugular veins in one hundred adult patients under general anesthesia using echo image. The vertebral artery could be observed in all patients under the level of cricoid cartilage. Vertebral arteries ran in an outward direction toward the caudal side (3.9 mm lateral and 14.6 mm deep from the internal jugular vein : median). Mean width of vertebral artery was 4.2 mm. Because the width of central venous catheter guide wire is approx. 1 mm, accidental puncture of a vertebral artery can occur through the internal jugular vein during central venous catheterization. By the use of ultrasound analysis, the vertebral artery could be observed completely. It is important to identify the location of vertebral arteries under the level of cricoid cartilage and avoid the tap toward the lateral side. We can avoid accidental puncture of vertebral artery by taking care of these points.