M. Staneva 1, P. Antova 1, Ts. Tsvetanov 1, G. Simeonov 2, B. Minkova 1, I. Staikov 3
1 Department of Vascular Surgery and Angiology,
2 Department of Anesthesiology and Intensive Care,
3 Department of Neurology, Tokuda Hospital – Sofia, Bulgaria
Objective: The ain of this prospective study is to define the clinical significance of diagnosis partial or complete thrombosis of Internal jugular vein (IJV) after insertion of a central venous catheter (CVC) in patients in intensive care unit (ICU).
Materials and Methods: Central venous catheter in IJV is implanted to 233 patients for the period 03.2013 to 05.2013. From all the patients 135 are men, 98 are women, mean age 60,6 years. The IJV is evaluated with Color-coded Duplex Ultrasound (CDU), before insertion of the CVC and at the 7th post procedure day, for the existence of partial or complete thrombosis. Some of the patients with trombosis were symptomatic of thet, other – were asymptomatic. Degree of thrombosis was: incomplete small (less than 50% of the lumen); incomplete high (more than 50% of the lumen) and complete thrombosis. While staying in ICU were used to prophylaxis thrombosis low-molecular-weight heparin and antibiotics.
Results: At the 7th day thrombosis is diagnose at 77 (33%) patients with CDU, 41 (53%) are men and 36 (47%) are women (p>0,05). Asymptomatic thrombosis are 67 (87%), and symptomatic-10 (13 %), p<0,05. Incomplete small thrombosis is diagnosed in 56 (73%) patients, incomplete high-14 (18%) and complete thrombosis - 7(9%) patients, (p<0,05).
Discussion: The thrombosis of IJV is an important complication, which increases hospital stay and worsens the patient's condition. The majority of them remain undiagnosed. The frequency of symptomatic stenosis is low, and asymptomatic frequency is high. Color-coded duplex sonography is a method of choice to examine IJV in the extracranial segment and for diagnosing thrombosis.
Key words: color-coded duplex ultrasound, internal jugular vein, thrombosis.