title: Variations in the anatomical relationship between the common carotid artery and the internal jugular vein: an ultrasonographic study.
abstract: BACKGROUND
  The internal jugular vein locates anterior or anterolateral to the common carotid artery in two-thirds of the subjects studied by ultrasound when the head is in a rotated position.
  
  
  OBJECTIVE
  To identify variables associated with the anterior location of the internal jugular vein.
  
  
  METHODS
  Ultrasound examinations were performed with the patients in the supine position, with the head rotated to the opposite side. The proximal third of the neck was visualized transversely with a 7.5-mHz transducer. The relationship between the vessels was described in accordance with the proportion of the artery overlapped by the vein. Univariate comparisons and a multivariate analysis of potential variables that may affect the anatomic relationships were performed.
  
  
  RESULTS
  Seventy-eight patients were included, 44 of whom were men. The patients' ages ranged from 17 to 90 years (median 64.0, interquartile range 41-73). The right and left sides were studied 75 and 73 times, respectively. The vein was located lateral to the artery in 24.3% (95%CI= 17.4-32.2) of the studies, anterolateral in 33.8% (95%CI= 26.2-41.4) and anterior in 41.9% (95%CI= 33.9-49.8). The multivariate analysis identified age group (OR= 3.7, 95% CI 2.1-6.4) and, less significantly, the left side (OR= 1.7, 95%CI= 0.8-3.5) and male gender (OR= 1.2, 95%CI= 0.6-2.7) as variables associated with the anterior position of the vein.
  The anterior position of the internal jugular vein relative to the common carotid artery increases gradually with age. Additionally, left-sided localization and male sex further increased the probability of an anterior position.
authors: Emergency Physician. Intensive Care Fellow, Universidad del Valle, Fundación Valle del Lili, Cali, Valle, Colombia.
authors: Mauricio
authors: M
authors: Umaña
authors: Surgeon Intensivist. Universidad del Valle, Intensive Care Unit, Fundación Valle del Lili, Cali, Valle, Colombia.
authors: Alberto
authors: A
authors: García
authors: Emergency Physician. Intensive Care Fellow, Universidad del Valle, Fundación Valle del Lili, Cali, Valle, Colombia.
authors: Luis
authors: L
authors: Bustamante
authors: Emergency Physician. Intensive Care Fellow, Universidad del Valle, Fundación Valle del Lili, Cali, Valle, Colombia.
authors: José Luis
authors: JL
authors: Castillo
authors: General Surgeon. Intensive Care Fellow, Universidad del Valle, Fundación Valle del Lili, Cali, Valle, Colombia.
authors: Juan
authors: J
authors: Sebastián Martínez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017536:Carotid Artery, Common / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012737:Sex Factors; D016683:Supine Position; D014463:Ultrasonography; D055815:Young Adult
keywords: Ultrasound; anatomy; carotid artery; central venous catheterization; internal jugular vein