Anatomic relationship of the internal jugular vein and the common carotid artery in Chinese people

摘要

＜正＞ Background Variations in position and relationship between the internal jugular vein （IJV） and the common carotidartery （CCA） may lead to inadvertent artery puncture which could be disastrous during central venous access.Wedemonstrated the anatomic relationship of the IJV with CCA in order to find the optimal site and avoid damage of CCA.Methods Two hundred and twenty surgical patients were enrolled.We analyzed the distance and relationship betweenthe IJV and CCA at three cross sections （upper border of the thyroid cartilage,cricoid cartilage and second tracheal ring） byultrasonography and then measured the diameters of the IJV and CCA and the distances from the IJV and CCA to the skin.Results Twenty patients were excluded on the basis of exclusion criteria.From up to down at bilateral neck,the IJVbecame gradually more superficial while the CCA became deeper.The diameter of the IJV became gradually larger whilethat of the CCA gradually smaller.The IJV from lateral to the CCA gradually moved to the front of the CCA,so the percentoverlap of the IJV and CCA was gradually increased.Compared with the left side at the same transverse scan level,thedistance between the CCA and IJV was wider at the right side and the right IJV was wider.The IJV location in 11 patientswas medial to the CCA at one or more transverse scan levels.The angle between the IJV and CCA was significantlysmall in elderly patients.The CCA had already furcated at the level of the upper border of the thyroid cartilage in sevenpatients at the right side and in 12 patients at the left side.Conclusions There are variations in the position and relationship between the IJV and CCA.It is relatively moredifficult to puncture at the left side of the neck,at a lower position or in elderly patients.On the contrary,it is relativelyeasier to puncture at the right side,at the level of the cricoid cartilage or in younger patients.