Fundamental Procedural Radiology Peri-Procedural Tasks: Establishing Vascular Access Into The Internal Jugular Vein

OVERVIEW

This page is dedicated to discussing how to establish internal jugular vein access. This is a very common initial step taken for various types of radiology procedures, and is an important skill to possess for any procedural radiologist who will be doing endovenous work.

This ultrasound image is from a chest port procedure where a micro puncture needle (NT stands for needle tip) has been inserted into the internal jugular vein (IJ) to gain access into the vessel. The carotid artery (CA) is also seen on this image.

The sections below provide more in depth explanation about the various aspects involved in gaining access to the internal jugular vein. The overview video may be all that is required for a refresher for more advanced viewers, however the following videos help to go in further depth on key topics that relate to gaining access into the internal jugular vein. 

INTERNAL JUGULAR VENOUS ACCESS RAPID REVIEW

This video provides a comprehensive (but rapid) overview regarding how to gain access into the internal jugular vein. If you would like more clarification about certain steps regarding internal jugular vein access please refer to the other videos on this page.

ULTRASOUND SCANNING FOR INTERNAL JUGULAR VENOUS ACCESS

This video discusses how to scan with ultrasound to evaluate for the internal jugular vein, before attempting to access the internal jugular vein.

ACCESS ORIENTATIONS: PARALLEL VS. PERPENDICULAR TO THE VESSEL

It is important to remember that the internal jugular vein can be accessed in a plane that is either parallel or perpendicular to its long axis. Knowing which you plan on doing before beginning your procedure is useful as it will change some technical considerations (as discussed in this video).

PREPARING THE SKIN PRIOR TO ACCESS

Before you can access the internal jugular vein, the skin puncture site must be marked and prepared. This video discusses what needs to be done after you have picked your target but before you actually access the internal jugular.

PREPARING THE MICROPUNCTURE KIT PRIOR TO ACCESS
This video discusses how you should prepare your micropuncture kit before trying to gain access into the internal jugular vein. Following the steps in this video will help make sure that internal jugular venous access goes smoothly.

HOW TO HOLD THE ULTRASOUND PROBE

This video goes in depth about how to hold the ultrasound probe when trying to gain access into the internal jugular vein. It may seem like a simple concept, however it is very helpful to make sure that the probe is held correctly and in a way that will make it easy to perform the rest of the procedure.

HOLDING THE MICROPUNCTURE NEEDLE PROPERLY

This is a short and simple video that discusses how to hold the micropuncture needle properly.

GAINING ACCESS: PARALLEL TO THE VESSEL AXIS
This video goes over all the steps of how to gain access into the internal jugular vein beginning with giving lidocaine to numb up the prospective needle path, and ending with securing access with the wire you will be using for the case (after access is gained). This particular video demonstrates venous access that is parallel to the vessel axis.

GAINING ACCESS: PERPENDICULAR  TO THE VESSEL AXIS
This video goes over all the steps of how to gain access into the internal jugular vein beginning with giving lidocaine to numb up the prospective needle path, and ending with securing access with the wire you will be using for the case (after access is gained). This particular video demonstrates venous access that is perpendicular to the vessel axis.

 

Page Updated: 09.20.19