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Surgically important variations of the jugular veins

Nayak BS

Clin Anat, 2006 Sep;19(6):544-6.

Knowledge of variations of veins of head and neck in relation to external jugular, anterior jugular, internal jugular, and facial veins is important to surgeons doing head and neck surgery as well as to radiologists doing catheterization and to clinicians in general. In the current case, multiple variations in the veins of the left side of neck are reported. The anterior division of retromandibular vein was absent. The facial vein continued as anterior jugular vein. The internal jugular vein was duplicated above the level of hyoid bone. There was a large communicating vein between the anterior jugular vein and anterior division of internal jugular vein. Lingual vein drained into the communicating vein. Jugular venous arch was abnormally large, doubled, and highly placed. The veins of the right side were normal.

Matched MeSH terms: Jugular Veins/anatomy & histology*

Fulltext Patterns of superficial veins of the cubital fossa in Malays

Dharap AS, Shaharuddin MY

Med J Malaysia, 1994 Sep;49(3):239-41.

PMID: 7845272

Patterns of superficial veins of the cubital fossa were studied in 170 male and 96 female Malays. Six venous patterns were observed. The less commonly known but clinically important patterns observed included absence of communication between basilic and cephalic veins (in 7.3% females and 8.8% males); an arched median cubital vein (in 2.0% females and 6.5% males); absence of the cephalic vein (in 1.0% females and 2.9% males) and two median cubital veins (in 1 male only). Awareness of these uncommon cubital venous patterns and their approximate incidence would be very useful for those performing venepuncture or venesection in Malays, especially under emergency conditions.

Matched MeSH terms: Veins/anatomy & histology*

Accessory sulci of the liver. An anatomical study with clinical implications

Othman FB, Latiff AA, Suhaimi FH, Das S

Saudi Med J, 2008 Sep;29(9):1247-9.

PMID: 18813405

To study the presence of accessory sulcus (AS) in the embalmed cadaveric livers, and compare it with the normal liver.

Matched MeSH terms: Hepatic Veins/anatomy & histology

Patterns of the superficial veins of the cubital fossa: A meta-analysis

Yammine K, Erić M

Phlebology, 2017 Jul;32(6):403-414.

PMID: 27343223 DOI: 10.1177/0268355516655670

Background The aim of this systematic review is to quantitatively synthesize evidence on the prevalence of superficial vein patterns in the cubital region. Method A systematic literature search was conducted through a number of electronic databases. We identified 27 studies, including 9924 arms, which met the inclusion criteria. Results Meta-analysis showed that "N" shaped arrangement type was the commonest pattern (≈44-60%) followed by "M" shaped arrangement (≈20-25%). The prevalence of "M" type and "M"-like type was significantly higher in males, whereas females showed a significant predominance of "I" or "O" type. No significant differences in various pattern types were found for laterality. The frequency of "M" type is significantly lesser in Indian and Japanese populations, but they have significantly higher frequency of "N" type. In Malay population, "I" or "O" type was significantly higher, while the brachial CV was poorly developed or missing significantly in Indian population. Conclusion This evidence-based clinical anatomy review contributes to our anatomical knowledge regarding the true prevalence of pattern types of the superficial veins in cubital region in humans and, subsequently, might help in performing safer venous access and more direct approaches to these veins, especially under emergency conditions.

Matched MeSH terms: Veins/anatomy & histology*

Fulltext Ultrasound Probe Positions for Internal Jugular Vein Cannulation: A Prospective Study of Different Techniques

Kurien M, Teo R, Zainuddin K, Azidin AM, Izaham A, Budiman M, et al.

Clin Ter, 2021 Jul 05;172(4):278-283.

PMID: 34247211 DOI: 10.7417/CT.2021.2332

Objective: We compared sonoanatomy of the internal jugular vein (IJV) the high (HA), conventional (CA) and the medial oblique approach (MA) to identify the best approach and head position for IJV cannulation.

Materials & Methods: Total of 45 volunteers aged 18-65 years were included in this study. The degree of overlap in percentage, depth of IJV from skin, antero-posterior (AP) and transverse diameters (TD) of IJV were measured in real time with ultrasound (US). Measurements were taken in the HA, CA and MA in neutral and 30° head rotation on both the right and left side of the neck.

Results: The HA had lower percentage of overlap when compared to CA and MA in neutral and 30° head rotation (p= 0.002 to ≤0.001). The IJV was more shallow in the CA and MA. The AP and TD of the IJV were larger in the MA when compared to HA (p=<0.001) and CA (p =0.026 to < 0.001) and the right IJV has a larger AP and TD in all approaches.

Discussion: The HA had the least percentage of overlap compared to CA and MA, therefore the risk of accidental ICA puncture can be reduced. The apparent overlap seen in MA may not reflect the actual scenario because of the way the US beam cuts the vessel. The AP and TD of IJV were significantly increased in the MA, which would ease CVC.

Conclusion: We conclude and recommend the medial oblique probe position with 30° head rotation provides optimal real time sonographic parameters for US guided IJV cannulation.

Matched MeSH terms: Jugular Veins/anatomy & histology*

Fulltext Gigantism of the lower limb in Klippel-Trenaunay syndrome: anatomy of the lateral marginal vein

Abdul-Rahman NR, Mohammad KF, Ibrahim S

Singapore Med J, 2009 Jun;50(6):e223-5.

PMID: 19551303

The Klippel-Trenaunay syndrome is a combination of venous and capillary malformations associated with soft tissue and/or bony limb hypertrophy, with or without lymphatic malformations. Although persistent foetal veins are rare, the persistence of the lateral marginal vein is a common association in this syndrome. It results in venous hypertension, which gives rise to venous varicosities, which are commonly seen in this syndrome. This is a case report of a 28-year-old man with Klippel-Trenaunay syndrome, with persistence of the lateral marginal vein, affecting his right lower limb. He was treated with an above-knee amputation. The amputated limb was dissected to demonstrate the anatomy of the lateral marginal vein. To the best of the authors' knowledge, the gross anatomy of the lateral marginal vein has not been previously reported.

Matched MeSH terms: Veins/anatomy & histology*

Fulltext Surgical and embryological perspective of a big loop of internal carotid artery extending laterally beyond internal jugular vein

Nayak SB, Shetty SD

Surg Radiol Anat, 2021 Mar;43(3):413-416.

PMID: 33231750 DOI: 10.1007/s00276-020-02619-z

Knowledge of variations of the internal carotid artery is significant to surgeons and radiologists. The internal carotid artery normally runs a straight course in the neck. Its anomalies can lead to its iatrogenic injuries. We report a case of a large loop of the internal carotid artery in a male cadaver aged about 75 years. The common carotid artery terminated by dividing it into the external carotid artery and internal carotid arteries at the level of the upper border of the thyroid cartilage. From the level of origin, the internal carotid artery coursed upwards, backwards and laterally, and formed a large loop behind the internal jugular vein. The variation was found on the left side of the neck and was unilateral. The uncommon looping of the internal carotid artery might result in altered blood flow to the brain and may lead to misperceptions in surgical, imaging, and invasive procedures.

Matched MeSH terms: Jugular Veins/anatomy & histology

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