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At least 19 recordsLinked to original sources
PubMed1996

Prospective randomized trial of carotid endarterectomy with primary closure and patch angioplasty with saphenous vein, jugular vein, and polytetrafluoroethylene: perioperative (30-day) results.

PURPOSE: The early outcomes of carotid endarterectomy (CEA) with primary closure (PC) versus vein patch closure (saphenous vein [SVP] and jugular vein [JVP]) and polytetrafluoroethylene patch closure (PTFE-PC) were compared. METHODS: Three hundred ninety-nine CEAs were randomized into the following groups: 135 PC, 134 PTFE-PC, and 130 vein patch closure (SVP alternating with JVP). Surviving patients underwent a carotid color duplex ultrasonographic scan 1 month after surgery. Demographic characteristics were similar in all groups. RESULTS: The incidence of perioperative cerebrovascular accidents (CVAs) was 4.4% for PC, 0.8% for PTFE-PC, and 0% for vein patch closure (PC vs vein patch, p = 0.0165; PC vs all patching [vein and PTFE], p = 0.007). The perioperative CVA and reversible ischemic neurologic deficit (RIND) combined rates for all patching were superior to PC (1.5% vs 5.2%; p = 0.04). These combined rates were also superior for vein patch closure when compared with PC (0.8% vs 5.2%; p = 0.037). The mean diameter of the internal carotid artery was similar in patients who had perioperative neurologic deficits and those who did not. After 1 month of follow-up, 11.9% of the PC arteries were narrowed 50% or more in contrast to 2.3% for PTFE-PC, 3.1% for SVP, and 10.3% for JVP.

Aged↗
PubMed1998

Prospective randomized trial of carotid endarterectomy with primary closure and patch angioplasty with saphenous vein, jugular vein, and polytetrafluoroethylene: long-term follow-up.

PURPOSE: This study examines the long-term clinical outcome and the incidence of recurrent stenosis (> or = 50%) after carotid endarterectomy (CEA) with primary closure (PC) versus vein patch closure (VPC), saphenous (SVP), and jugular vein (JVP) and polytetrafluoroethylene patch closure (PTFE-P). METHODS: A total of 399 CEAs were randomized into the following groups: 135 PC, 134 PTFE-P, and 130 VPC (SVP alternating with JVP). Postoperative duplex ultrasound scans were performed at 1, 6, and 12 months and every year thereafter. The mean follow-up was 30 months with a range of 1 to 62 months, and demographic characteristics were similar in all groups. Kaplan-Meier analysis was used to estimate the risk of restenosis and the stroke-free survival. RESULTS: The incidence of ipsilateral stroke was 5% (seven of 135) for PC, 1% (one of 134) for PTFE-P, and 0% for VPC (PC vs VPC, p = 0.008; PC vs PTFE-P, p = 0.034). Seven strokes occurred in the perioperative period. All three groups had similar mortality rates. The cumulative stroke-free survival rate at 48 months was 82% for PC, 84% for PTFE-P, and 88% for VPC (p < 0.01 for PC vs PTFE-P or VPC). PC had a higher incidence of recurrent stenosis and occlusion (34%) than PTFE-P (2%) and VPC (9%) (SVP 9%, JVP 8%) (p < 0.001). PTFE-P had a lower recurrent stenosis rate than VPC (p < 0.045). Restenoses necessitating a redo CEA were also higher for PC (11%) than for PTFE-P (1%) and VPC (2%) (p < 0.001). Women with PC had a higher recurrent stenosis rate than men (46% vs 23%, p = 0.008). Kaplan-Meier analysis showed that freedom from recurrent stenosis at 48 months was 47% for PC, 84% for VPC, and 96% for PTFE-P (p < 0.001). The SVP and JVP results were comparable. The mean operative diameter of the internal carotid artery was similar in patients with or without restenosis. Significantly more late internal carotid artery dilatations occurred in the VPC group compared with the PC group. CONCLUSIONS: Patch closure (VPC or PTFE-P) is less likely than PC to cause perioperative stroke. Patching was also superior in lowering the incidence of late recurrent stenoses, especially in women.

Angioplasty↗
PubMed1984

[The effect of zeolite (clinoptilolite) on the post-feeding dynamics of N metabolism in the portal vein, jugular vein and the rumen fluid of bulls].

If easily digestible saccharides are deficient in the feed ration of bulls with the live weight of 300 kg and at simultaneous single application of urea at a rate of 0.2 g per 1 kg live weight, zeolite (with 50.6% clinoptilolite content) administered at a rate of 2.5% per 1 kg dry matter influenced significantly (P less than 0.05) the ammonia concentration in rumen, v. portae and v. jugularis. The rumen contents and blood were sampled at the intervals of 0, 15, 30, 60, 90, 120, 180 and 360 minutes after feeding. Basal feed ration consisted of 1 kg feed mixture and 3 kg meadow hay. After urea administration, zeolite reduced the ammonia concentration in rumen by 20-40% in comparison with the control group and in v. portae by 60-70%. In v. jugularis in the 90th minute after feeding significant hyperammonemia was observed in bulls with no zeolite supplement. Zeolite administration did not influence urea concentration in plasma.

Aluminum Silicates↗
PubMed1997

Prediction of a small internal jugular vein by external jugular vein diameter.

The relationship between internal jugular vein diameter as measured with an ultrasound imaging machine (SiteRite, Dymax) and external jugular vein diameter was studied in 50 anaesthetised patients undergoing elective cardiac surgery. There was an inverse correlation between external jugular vein diameter and internal jugular vein diameter (r = -0.47, p < 0.001). All patients with an external jugular vein diameter of 7 mm or greater had an internal jugular vein diameter of less than 15 mm. No patient with an external jugular vein diameter of less than 7 mm had an internal jugular vein diameter of less than 20 mm. No other patient dimension (height, weight, body mass index, neck circumference) predicted internal jugular vein size. These results suggest that a large external jugular vein (i.e. 7 mm or greater in external diameter) may be associated with a small internal jugular vein. A size 5.0-mm internal diameter tracheal tube may be used to provide a rapid assessment of external jugular vein diameter.

Adult↗
PubMed1995

A comparative study of saphenous vein, internal jugular vein, and knitted Dacron patches for carotid artery endarterectomy.

To determine whether the choice of material used for patch closure following carotid artery endarterectomy (CAE) affected the immediate operative results, the early follow-up results, or the incidence of early restenosis, a retrospective study of 275 consecutive carotid endarterectomies by two vascular surgeons was performed. Among 275 primary CAEs performed between July 1991 and August 1993, 159 (57.8%) were closed with saphenous vein (SV), 25 (9.1%) with double-thickness internal jugular vein (JV), and 91 (33.1%) with knitted Dacron (KD). Primary closure was not used in any of the arteries in this series. The overall perioperative mortality rate was 1.1% and the rate of major and minor morbidity was 4.4% There were four (1.5%) perioperative strokes: two (1.3%) in the SV group, one (4.0%) in the JV group, and one (1.1%) in the KD group. Two-hundred fifty-eight (93.8%) of the 275 endarterectomies were followed postoperatively for 2 to 35 months (mean 14.4). Two-hundred nineteen (79.6%) were evaluated using duplex scans during follow-up with a mean interval of 13.7 months. Of the arteries studied, four (3.6%) in the SV group, none in the JV group, and six (8.4%) in the KD group demonstrated restenosis of > 50% at the time of follow-up (NS). In addition, one (0.9%) artery in the SV group, one (5.6%) in the JV group, and none in the KD group demonstrated complete occlusion. Retrospective analysis of the data showed no statistically significant differences in perioperative morbidity, mortality, or early postoperative restenosis whether the artery was closed with saphenous vein, jugular vein, or knitted Dacron patches. Longer follow-up is needed to determine whether rates of late restenosis and aneurysmal dilation will differ between synthetic and autologous patches.

Aged↗
PubMed2001

Internal jugular vein versus external jugular vein anastamosis: implications for successful free tissue transfer.

BACKGROUND: Microvascular free flaps are becoming the reconstructive option of choice for many head and neck defects. Many previous studies have examined factors predicting free flap survival. No study has compared differences in free flap survival when anastomosed to the internal or external jugular systems. METHODS: Retrospective review of all free flaps performed at an academic medical center by a single head and neck microvascular surgeon during the period July 1995 to December 1999. Flaps were closely monitored postoperatively and taken back to the operating room urgently for arterial insufficiency or venous congestion. RESULTS: On hundred fifty-six free flaps were performed during this time period. Sixty-five free flaps were anastomosed to the external jugular (EJ) vein and 86 to the IJ system (62 to the proximal common facial vein, 17 end-side on the IJ, and 7 to other branches). Five had either two venous anastomoses or were anastomosed to other veins and were excluded from statistical analysis. Six (4%) vascular thromboses occurred; 5 were venous and 1 arterial. Success by group was 99% for IJ anastomosis (1 arterial thrombosis) and 92% for EJ anastomosis (5 venous thromboses, p =.03). Urgent anastomotic revision and reperfusion salvaged 5 of the 6 flaps (overall success 99%). CONCLUSIONS: Although the overall success rate (96% success with 99% success with salvage) is comparable to other large series, microvascular free flaps anastomosed to the external jugular vein failed at a significantly higher rate than those anastomosed to the IJ system. This suggests that the IJ system should be used as a recipient vessel when feasible.

Anastomosis, Surgical↗
PubMed2001

Long-term follow-up of saphenous vein, internal jugular vein, and knitted Dacron patches for carotid artery endarterectomy.

To determine whether choice of material used for patch closure following carotid artery endarterectomy (CAE) influences rates of early or late restenosis, stroke, and death, 274 consecutive CAEs were retrospectively reviewed. Saphenous vein (SV) was used in 159 (58.0%) procedures; everted, double-thickness jugular vein (JV) was used in 25 (9.1%); and knitted Dacron (KD) was used in 90 (32.9%). Primary closure was not used in this series. There were four perioperative strokes: two (1.3%) in SV, one (4%) in JV, and one (1.1%) in KD (NS). Follow-up was obtained on 263 (96%) operated arteries (mean 41.5 months). Duplex scan results were available for 236 (89.7%) of these arteries (mean follow-up time 33.7 months). There were three (2%) late strokes in SV and two (2.2%) in KD (NS). In long-term follow-up, one patient (0.7%) in SV and two (2.4%) in KD developed > 80% stenosis (NS). One patient (0.7%) in SV, one (5.3%) in JV, and one (1.2%) in KD had total occlusion of the operated vessel (NS). Three procedures (2.2%) in SV, 1 (5.3%) in JV, and 7 (8.5%) in KD demonstrated moderate stenosis (50-79%) (NS). Three-year follow-up shows that choice of patch material does not affect early or late stroke rate, stroke-related death rate, rate of high-grade (> 80%) restenosis, or rate of total occlusion. There is a higher incidence of moderate stenosis in KD. Although our results and a review of the literature do not indicate that these patients are at increased risk for symptoms or progression of stenosis, they should be followed by duplex scanning to ensure that this is the case.

Aged↗
PubMed1998

Autogenous common facial vein or external jugular vein patch for carotid endarterectomy.

BACKGROUND: The purpose of this study was to determine whether common facial vein or external jugular vein are as good a vein patch as a saphenous vein for carotid patch angioplasty. METHOD: Retrospectively, 19 patients who underwent everted common facial vein or external jugular vein patch were compared with 199 patients who underwent saphenous vein patch carotid endarterectomy during 1989 to 1996. The two groups were compared clinically and by sonographic surveillance. The mean follow-up was 18+/-4 months for common facial vein/external jugular vein patients and 48+/-15 months for saphenous vein patch group. RESULTS: No significant differences in mortality or morbidity were observed among patients in whom everted common facial vein or external jugular vein was used as compared with saphenous vein. No bleeding, thrombotic event, dilation of the patch or aneurysmal degeneration and perioperative deaths occurred in either of the two groups. Duplex surveillance studies showed no significant difference in recurrent moderate (50-79%) and severe (80-99%) stenosis. CONCLUSION: Everted common facial vein or external jugular vein patch was comparable to other vein patches. This eliminates the comorbidity of groin incision. Also, using everted common facial vein or external jugular vein as vein patch saves saphenous vein to be used for other vascular procedures, such as coronary artery or lower extremity bypass.

Aged↗
PubMed1978

Comparison between tail vein and jugular vein cannulation in cattle.

Blood samples obtained simultaneously from the jugular and tail (coccygeal) veins during induction of bovine mastitis infection and after administration of 250 IU of adrenocorticotropin did not differ in percentage of hematocrit, concentration of total corticosteroid in plasma, or concentrations of total circulating erythrocytes and leukocytes. Patency of the tail vein cannula was maintained for 1 mo. Tail vein cannulation is a practical alternative to jugular cannulation in cattle.

Animals↗
PubMed1989

[Thromboses of the subclavian vein and jugular vein and superior vena cava: sonographic diagnosis and control of treatment using tissue-type plasminogen activator therapy].

In the suspected diagnosis "superior influx congestion" sonography performed with the 5 MHz linear scanner is suitable as a non-invasive method for the primary diagnosis of thrombotic occlusions of the vena subclavia and vena jugularis interna, and for follow-up monitoring under thrombolytic therapy. In successful lysis it is possible to verify a sonomorphological and Doppler sonographic sequence of stages from the freshly formed, stratified stage via the high-echo to the low-echo thrombus with formation of lacunae, as well as the recanalisation that is seen at first only at the margins and eventually becomes complete with a flow that varies with the respiration.

Female↗
PubMed2001

Internal jugular vein occlusion test for rapid diagnosis of misplaced subclavian vein catheter into the internal jugular vein.

BACKGROUND: During subclavian vein catheterization, the most common misplacement of the catheter is cephalad, into the ipsilateral internal jugular vein (IJV). This can be detected by chest radiography. However, after any repositioning of the catheter, subsequent chest radiography is required. In an effort to simplify the detection of a misplaced subclavian vein catheter, the authors assessed a previously published detection method. METHODS: One hundred adult patients scheduled for subclavian vein cannulation were included in this study. After placement of subclavian vein catheter, chest radiography was performed. While the x-ray film was being processed, the authors performed an IJV occlusion test by applying external pressure on the IJV for approximately 10 s in the supraclavicular area and observed the change in central venous pressure and its waveform pattern. The observations thus obtained were compared with the position of catheter in chest radiographs, and the sensitivity and specificity of this method were evaluated using a 2 x 2 table. RESULTS: In 96 patients, subclavian vein cannulation was successfully performed. In four patients, cannulation was unsuccessful; therefore, these patients were excluded from the study. There were six misplacements of venous catheters as detected by radiography. In five (5.2%) patients, the catheter tip was located in the ipsilateral IJV, and in one (1.02%), the catheter tip was located in the contralateral subclavian vein. In the patients who had a misplaced catheter into the IJV, IJV occlusion test results were positive, with an increase of 3-5 mmHg in central venous pressure, whereas the test results were negative in patients who had normally placed catheters or misplacement of a catheter other than in the IJV. There were no false-positive or false-negative test results. CONCLUSION: The IJV occlusion test successfully detects the misplacement of subclavian vein catheter into the IJV. However, it does not detect any other misplacement. The test may allow avoidance of repeated exposure to x-rays after catheter insertion and repositioning.

Adult↗
PubMed1979

Microscopic studies on the transition between the sigmoid sinus, the superior bulb of the jugular vein and the first portion of the internal jugular vein.

The author studied the structure of the tissue components of the tunicae of the terminal segment of the sigmoid sinus, particularly at the level of the transition between the sigmoid sinus, the superior bulb of the jugular vein and the first portion of the human internal jugular vein; it was established that the transition between the sigmoid sinus and the first portion of the internal jugular vein occupies the whole extension of the superior bulb of the jugular vein up to the inferior third of the first portion of this vessel. These vascular walls exhibit a structure similar to that of the dura, i.e. the tunica adventitia is formed by fascicles of collagenic fibers which describe discontinuous spirals, more open proximal to the beginning of the first portion of the internal jugular vein. Approximately in the inferior third of the first portion of the internal jugular vein, there appear fascicles of smooth muscle fibers which are arranged similarly to those of the venous walls. The tunica intima of these vascular segments exhibits an endothelium resting on a network of elastic fibers which may play the role of an internal elastic lamina. From the bony border of the jugular foramen there originates a connective system whose fascicles of collagenic and elastic fibers incorporate to the wall of the internal jugular vein after describing a stretch in spiral around the vascular lumen.

Collagen↗
PubMed2004

Phlebectasia of the external jugular vein associated with duplication of the internal jugular vein.

The most common cause of a neck mass that increases in size on the Valsalva maneuver is laryngocele. Jugular phlebectasia is a congenital dilation of the jugular vein, which is extremely rare in adults, may present similarly. Duplication of the internal jugular vein (IJV), which is usually encountered coincidentally, is another rare anatomic variation. Isolated cases or cases associated with IJV ectasia have been reported. We report on an adult patient with coexisting external jugular phlebectasia and internal jugular duplication on the same side.

Diagnosis, Differential↗
PubMed2003

Facial vein draining into external jugular vein in humans: its variations, phylogenetic retention and clinical relevance.

The superficial veins, especially the external jugular vein (EJV), are increasingly being utilized for cannulation to conduct diagnostic procedures or intravenous therapies. Ultrasound-guided venipuncture is a viable possibility in cases of variations in the patterns of superficial veins, and their knowledge is also important for surgeons doing reconstructive surgery. This study was done on 89 dissected adult cadavers (178 sides) and variations in patterns of termination of the facial vein (FV) into the EJV were studied. The FV in 16 sides (9%) was found to drain into the EJV, in two main patterns: type I and type II. Type I had the FV draining into the EJV with varying degrees of obliquity in a Y-shaped (6 cases, 37.5%), U-shaped (3 cases, 18.7%), tuning-fork-shaped (2 cases, 12.5%) or N-shaped (1 case, 6.2%) pattern. Type II showed an inverted A-shaped pattern (2 cases, 12.5%) or a stepladder-shaped pattern (2 cases, 12.5%) depending on the presence of one or more connecting conduits between the FV and EJV respectively. In Macaca mulatta(rhesus monkey) a pair of vertically disposed, subcutaneous veins placed nearly side by side and of equal caliber were seen on each side of the neck. The lateral vein was the EJV while the medial one took the course of the FV in the upper oblique segment and ran parallel to the EJV in the lower segment over the sternocleidomastoid, with one or two transverse communications. The anomalous patterns found in our study could be explained in terms of the regression and retention of various parts of the veins found in the rhesus monkey, or the drainage pattern found in horse, ox and dog, where the vein from the face drain into the external jugular vein, the internal jugular vein being either absent or a small vessel accompanying the carotid artery.

Adult↗