title: Use of the right external jugular vein as the preferred access site when the right internal jugular vein is not usable.
abstract: OBJECTIVE
  The present study describes the authors' experience with central venous access through the right external jugular vein (EJV) when the right internal jugular vein (IJV) is not available.
  
  
  METHODS
  A retrospective study of 23 patients in whom a central venous catheter placement was attempted via the right EJV was conducted. The reasons for catheterization via the right EJV included clinically silent occlusion of the right IJV (n = 17), localized skin infection overlying the right IJV related to a previous catheterization (n = 3), presence of an existing Hickman catheter in the right IJV (n = 1), and concern regarding the risk of catheter-related infection secondary to right IJV catheterization in patients with a tracheostomy tube device adjacent to the presumed site of right IJV catheterization (n = 2). Technical success, procedural complications, and follow-up results including catheter dwell time and delayed or late complications (eg, symptomatic venous thrombosis, catheter-related infection, and catheter malfunction) were assessed. Adverse events were expressed as events per 100 catheter-days of use.
  
  
  RESULTS
  Technical success was achieved in 22 of 23 patients (96%). There were no procedural complications. The catheter dwell time ranged from 2 to 182 days, with a mean dwell time of 62.7 days. There were four delayed or late complications (three catheter-related infections, 0.22 per 100 catheter-days; one catheter malfunction, 0.07 per 100 catheter-days). No cases of symptomatic venous thrombosis were noted.
  
  
  CONCLUSIONS
  The right EJV is an acceptable and preferred access site when the right IJV is not available for central venous catheterization.
authors: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul 135-710, Korea.
authors: Sung Ki
authors: SK
authors: Cho
authors: Sung Wook
authors: SW
authors: Shin
authors: Young Soo
authors: YS
authors: Do
authors: Kwang Bo
authors: KB
authors: Park
authors: Sung Wook
authors: SW
authors: Choo
authors: In-Wook
authors: IW
authors: Choo