Ultrasonographic evaluation of relationship between common carotid artery and internal jugular vein during head rotation

Abstract

IJV is most commonly used for central venous access as it is superficially located and fewer incidences 
of serious complications like pneumothorax and haemothorax compared with subclavian approach. The 
most common complication during IJV cannulation is accidental rupture of CCA. A cross-sectional study 
was performed on 100 patients coming to hospitals attached to Bangalore Medical College and Research 
Institute, Bengaluru. USG neck was performed to obtain the images of IJV and CCA on both sides with 
respect to different head rotations angles (0°, 15°, 30°, 45°, 60°, 75° and 90°) and results were calculated. 
Most common position of IJV is anterolateral with respect to CCA at any given head rotation angle. On 
turning head to contralateral position, IJV is noted displaced to anterior position. Percentage overlap of 
IJV to CCA significantly increases when head rotated >45° at 2 cm above the clavicle and > 30° at 4 cm 
above the clavicle.