Long Term Follow up of Neonatal Internal Jugular Vein Catheterization: Patency and Thrombosis

Document Type : Original Article


1 Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Parsian Medical Imaging Center, Mashhad, Iran.


Introduction: Maintaining a vascular access is a common procedure in neonates specifically for those who need prolonged hospitalization or intensive care support. This situation may happen several times among those with complex congenital anomalies therefore patency of central vein is a major concern at the time of re-cannulation. We evaluate the patency of internal jugular vein after previous open catheterization in this study.
Material and Method: All term neonates with documented internal jugular vein catheterization during 2008-2018 were enrolled in our study. Patients were fallowed for more than a year after catheter removal and internal jugular vein (IJV) patency was assessed by Doppler ultrasound.
Results: 87 neonates were undergone central venous catheterization while just 18 were participated in our study protocol successfully. Mean age at the time of catheterization was 16.22±8.14 days. Doppler ultrasound assessment was arranged meanly 29.2±6.53 months after catheter removal. Doppler ultrasound studies revealed normal patency in 38.9%, stenotic in 27.8% and occluded in 33.3% of cases. Mean age of catheterization was significantly lower in occluded IJV group while no meaningful correlation was detected between venous thrombosis and patient gender or catheter maintenance time. IJV occlusion rate was not related to the indication of catheterization
Conclusion: It is necessary to keep in mind the probability of IJV thrombosis and occlusion among those patients with the history of early neonatal ICU admission and CV catheterization. Ultrasound evaluation could be helpful while re-cannulation will be the best option for those with patent IJV to save the contra lateral venous patency.


  1. Jones SA, Giacomantonio M. A complication associated with central line removal in the pediatric population: retained fixed catheter fragments. Journal of pediatric surgery. 2003 Apr 1;38(4):594-6.
  2. Hong SM, Lee HS, Moon SB. Central venous cutdown in neonates: feasibility as a bedside procedure without general anesthesia. Journal of pediatric surgery. 2013 Aug 1;48(8):1722-6.
  3. Vierboom L, Darani A, Langusch C, Soundappan SV, Karpelowsky J. Tunnelled central venous access devices in small children: a comparison of open vs. ultrasound-guided percutaneous insertion in children weighing ten kilograms or less. Journal of pediatric surgery. 2018 Sep 1;53(9):1832-8.
  4. Kusminsky RE. Complications of central venous catheterization. Journal of the American College of Surgeons. 2007 Apr 1;204(4):681-96.
  5. Duke BJ, Ryu RK, Brega KE, Coldwell DM. Traumatic bilateral jugular vein thrombosis: case report and review of the literature. Neurosurgery. 1997 Sep 1;41(3):680-3.
  6. Cartwright DW. Central venous lines in neonates: a study of 2186 catheters. Archives of Disease in Childhood-Fetal and Neonatal Edition. 2004 Nov 1;89(6):F504-8.
  7. Grant EG, Benson CB, Moneta GL, Alexandrov AV, Baker JD, Bluth EI, et al. Carotid artery stenosis: gray-scale and Doppler US diagnosis—Society of Radiologists in Ultrasound Consensus Conference. Radiology. 2003 Nov;229(2):340-6.
  8. Alshafei A, Tareen F, Maphango N, White D, O'Connor B, Sriparan T. Open tunneled central line insertion in children—External or internal jugular vein?. Journal of pediatric surgery. 2018 Nov 1;53(11):2318-21.
  9. Khirallah MG, Elsharaby AM. Surgical insertion of central venous catheters in low-birth-weight neonates. Annals of Pediatric Surgery. 2015;11(4):218-21.
  10. Brasher C, Malbezin S. Central venous catheters in small infants. Anesthesiology. 2018 Jan;128(1):4-5.
  11. Mactier H, Alroomi LG, Young DG, Raine PA. Central venous catheterisation in very low birthweight infants. Archives of disease in childhood. 1986 May 1;61(5):449-53.
  12. Kim S, Kim Y, Moon SB. Histological changes of the unligated vein wall adjacent to the central venous catheter after open cutdown in rats. Journal of pediatric surgery. 2015 Nov 1;50(11):1928-32.
  13. Kurkluoglu M, Badia S, Peer SM, Jonas R, Shankar V, Sinha P. Patency of common carotid artery and internal jugular vein after a simple vessel sparing cannulation for extracorporeal membrane oxygenation support. Journal of pediatric surgery. 2017 Nov 1;52(11):1806-9.
  14. Roberts JP, Gollow IJ. Central venous catheters in surgical neonates. Journal of pediatric surgery. 1990 Jun 1;25(6):632-4.
  15. Gomes AV, Nascimento MA. Central venous catheterization in pediatric and neonatal intensive care units. Revista da Escola de Enfermagem da USP. 2013;47:794-800.