External Jugular Vein Research Articles

Drug Treatment by Central Venous Catheter in a Mouse Model of Angiotensin II Induced Abdominal Aortic Aneurysm and Monitoring by 3D Ultrasound.

Since pharmaceutical treatment options are lacking in the clinical management of abdominal aortic aneurysm (AAA), animal models, in particular mouse models, are applied to advance the understanding of the disease pathogenesis and to identify potential therapeutic targets. Testing novel drug candidates to block AAA growth in these models generally requires repeated drug administration during the time course of the experiment. Here, we describe a compiled protocol for AAA induction, insertion of an intravenous catheter to facilitate prolonged therapy, and serial AAA monitoring by 3D ultrasound. Aneurysms are induced in apolipoprotein E (ApoE) deficient mice by angiotensin II release over 28 days from osmotic mini-pumps implanted subcutaneously into the mouse back. Subsequently, the surgical procedure for external jugular vein catheterization is conducted to allow for daily intravenous drug treatment or repeated blood sampling via a subcutaneous vascular access button. Despite the two dorsal implants, the monitoring of AAA development is readily facilitated by sequential semi-automated 3D ultrasound analysis, which yields comprehensive information on the expansion of aortic diameter and volume and on aneurysm morphology, as illustrated by experimental examples.

Lemierre's syndrome from odontogenic infection causing thrombophlebitis within the external and internal jugular veins—A case report

AbstractLemierre's syndrome is a rare but potentially life‐threatening condition primarily caused by anaerobic bacteria within in the oropharyngeal region. It largely affects otherwise healthy individuals, following an oropharyngeal infection, leading to sepsis and thrombophlebitis of the internal jugular vein. Management can involve a prolonged course of antibiotics, exclusion of the source of infection, surgical drainage and anticoagulant therapy. This case report describes a rare presentation of this condition causing thrombosis within the external jugular vein and significant sepsis in an otherwise healthy 41‐year‐old male. He presented with severe neck pain and trismus, and the source of the infection was deemed to be an infected mandibular molar. The patient has undergone a full recovery following intravenous antibiotics, anticoagulation and later extraction of the offending tooth. Our aim is to educate clinicians on the importance of this uncommon but clinically significant condition, that is increasing in prevalence and can lead to significant morbidity.

Superficial Temporal Recipient Vessels for Craniofacial Microvascular Free-Flaps.

The selection of recipient vessels for microvascular free-flaps is critical in craniofacial reconstruction. Especially the suitability of the superficial temporal vessels is questioned conflictingly in the literature. The aim of this study was to share our experience with microvascular craniofacial free-flap reconstruction and to evaluate a set of factors that are related to the recipient vessels and to determine how these factors influence flap survival. We conducted a retrospective analysis of 39 free-flaps for craniofacial reconstruction that were performed from 2006 until 2020 and evaluated the indication for microvascular reconstruction, recipient vessels, various factors related to the recipient vessels and complications. The most utilized recipient artery was the facial artery, selected in 20 patients followed by the superficial temporal artery selected in 12 patients. The most commonly used recipient vein was the facial vein used in 16 patients, followed by the superficial temporal vein selected in 10 patients and the external jugular vein in 6 patients. Total flap necrosis occurred in one patient. There was no statistically significant association between the selected recipient vessels and patient comorbidities, major and minor complications, revision of anastomosis or flap loss. The results of our study have demonstrated that the superficial temporal artery and vein show similar results when used for face and scalp reconstruction. Considering their technical and aesthetic advantages they may be the first choice recipient vessels in established free-flap treatment algorithms for craniofacial reconstruction.

Abnormalities of External Jugular Veins in Bulldogs with Pulmonary Valve Stenosis

Simple SummaryThis case series is about two French bulldogs and one English bulldog affected by pulmonary valve stenosis that were diagnosed with different abnormalities of the external jugular veins (EJV) before a pulmonary balloon valvuloplasty. The EJV abnormalities encountered were severe hypoplasia of both external jugular veins and right external jugular vein absence, associated with persistent left cranial vena cava. All cases were diagnosed through computed tomography and vascular ultrasound. The aim of this case series is to describe external jugular veins abnormalities that can affect the decision-making process regarding central venous catheterization needed to perform procedures such as pulmonary balloon valvuloplasty or central catheter placement. Based on the results of the present case series, anomalies of the external jugular veins should be considered in French and English bulldogs when the external jugular veins cannot be clinically identified or when echocardiography shows coronary sinus dilation. Vascular ultrasound or computed tomography may help identify jugular venous anomalies and should be considered in the preoperative evaluation of bulldogs that need to undergo interventional procedures requiring transjugular catheterization.Two French bulldogs and one English bulldog affected by pulmonary valve stenosis and referred for pulmonary balloon valvuloplasty were diagnosed with different abnormalities of the external jugular veins. The diagnosis included unilateral absence of the right external jugular vein and bilateral hypoplasia of the external jugular veins, associated with persistent left cranial vena cava. Vascular ultrasound and computed tomography were used for the diagnosis. Jugular vein anomalies can affect decision-making regarding the central venous catheterization needed to perform procedures such as pulmonary balloon valvuloplasty or central catheter placement. Based on the results of the present case series, anomalies of external jugular veins should be considered in French and English bulldogs when the external jugular veins cannot be palpated or when echocardiography shows coronary sinus dilation. Vascular ultrasound or computed tomography may help identify jugular venous anomalies and should be considered in the preoperative evaluation of bulldogs that need to undergo interventional procedures requiring transjugular catheterization.

Subcutaneous vascular access port implantation in the axillary or femoral/external iliac vein at the time of full limb amputation in dogs.

To report outcomes and complications after placement of a subcutaneous vascular access port (SVAP) in the jugular (jSVAP), axillary (aSVAP), and femoral or external iliac vein (fSVAP) in dogs. Retrospective. Medical records from a single hospital, covering a period between September 2015 and October 2020, were reviewed to identify dogs that had an SVAP placed. Complications and outcomes for dogs who had an SVAP placed in the axillary vein, or femoral/external iliac vein during amputation for appendicular skeletal neoplasm, and in the external jugular vein were recorded and analyzed statistically. Subcutaneous vascular access ports were placed in the axillary vein in 13 dogs, femoral/external veins in 4 dogs, and in the jugular vein in 19 dogs. The SVAPs fulfilled their purpose throughout treatment in 12/13 aSVAP, 4/4 fSVAP, and 15/19 jSVAP. Dogs were followed for a median of 145.5 days (range 30-945 days). Minor and major complications were recorded in 1/13 and 2/13 aSVAPs, 0/4 and 0/4 fSVAPs, and 3/19 and 4/19 of jSVAPs. Two dogs with jSVAPs were euthanized due to SVAP-related complications. No difference in complication rate was detected between groups (P=.12). No difference in short-term outcome was detected between implantation sites for subcutaneous vascular access ports. The axillary or femoral/external iliac veins offer alternative sites for placement of SVAP in dogs undergoing limb amputation.

Rectus Abdominis Musculocutaneous Flap With Supercharging for Reconstruction of Extensive Thoracic Defect Due to Deep Sternal Wound Infection: A Case Report

Deep sternal wound infection is a serious postoperative complication of cardiac surgery and often requires flap reconstruction. Herein, we report a case of deep sternal wound infection with an extensive thoracic defect that was successfully treated using a modified technique. This technique, defined as “supercharging,” anastomoses the deep inferior epigastric artery and vein of pedicled rectus abdominis musculocutaneous flap to the transverse cervical artery and external jugular vein, respectively. The transverse cervical artery is an easily accessible and reliable recipient vessel. Therefore, we recommend that our technique be used, especially in cases of deep sternal wound infection with extensive thoracic defects.

VARIANT OF FETAL TOPOGRAPHY OF THE JUGULAR VEINS

An atypical case of the topography of the left external jugular vein and some extracranial tributaries of the left internal jugular vein in a 7-month-old human fetus is presented. The left external jugular vein is formed by two tributaries: the anterior (submandibular vein) and the posterior (posterior auricular vein), it fl ows into the left subclavian vein. The confl uence of the left lateral saphenous vein into the left external jugular vein, the absence of the left anterior jugular and occipital veins, and the absence of the anastomosis of the mandibular and the deep facial vein were found. The described case of the fetal topography of the left jugular veins will be of interest to both morphologists and fetal surgeons.

In vivo bone formation assessment using PRP with chitosan

Guided Bone Regeneration is a surgical treatment that involves the use of barrier membranes, particulate bone transplants, and/or bone substitutes. Sheep's weighted 20-30 kg were intubated and underwented general sedation with 0.03 mg / kg IM xylazine. The 8ml of blood was taken from external jugular vein of the sheep and immediately transferred in to citrated tube and transferred to centrifuge to prepare the PRP gel. The produced PRP was mixed with chitosan in 95:5 ratio. With a round bur and abundant irrigation, a 4-5 mm round osteotomy was formed in the pad of the maxilla with two in the right and two in the left side. Four equal defects were grafted with experimental material composed of mixed PRP and chitosan (95:5 ratio). After four weeks, the result show new bone formation around the defect side which was associated with interrupted fibrous connective tissue capsule for some of the samples with focal active osteoblasts. In ten weeks, the results show thick bones were newly formed at the defect side with remnants of chitosan observed at the site of bone. In conclusion: the present study revealed the combination of PRP and Chitosan accelerates the healing and regeneration of bones.

Safety of active pre-collision seat rotation strategies for autonomous vehicles: injury risk evaluation of occupant’s neck

The development of autonomous driving technology has engendered new requirements for the safety of the occupants of autonomous vehicles. Different variants of seat configurations, including face-to-face rides and rotating seats, have been implemented in autonomous vehicles. Furthermore, pre-collision active seat rotation strategies have been proposed for the safety of the occupants of autonomous vehicles. However, further evaluations are required to determine whether the active seat rotation strategy could cause injuries to the occupants during a significantly rapid rotation process. In this study, two types of multi-rigid body seat-occupant models and a finite element model of the occupant’s cervical spine were designed. The validity of the multi-rigid body model for the seat occupant was verified through a frontal collision simulation test. Considering the influence of different seat types and rotation directions on the risk of neck injuries to the occupants, four simulations were conducted based on the condition that the seat rotated by 90° in 200 ms. The kinematic and biomechanical aspects of the risk of injuries to the occupant’s cervical spine during the active seat rotation strategy were assessed, and the essential causes of these injuries were discussed. The results indicate that, in the absence of leg baffles and foot supports, seat rotation toward the diagonal line of the seatbelt poses different degrees of risk of injuries to the cervical spine, platysma, sternocleidomastoid, common carotid artery, external jugular vein, and internal jugular vein. Therefore, the seats of highly or fully autonomous vehicles should be designed to prevent this scenario.

External Jugular Vein Peripheral Intravenous Catheters: An Emergency Nurse’s Guide

Insertion of a peripheral intravenous catheter into the external jugular vein is regularly performed in emergency departments to treat patients with difficult intravenous access. Although emergency nurses are experienced in inserting peripheral intravenous catheters, there is an inconsistent practice and a lack of education and training regarding the insertion of catheters in the external jugular vein. This manuscript provides a practical guide for emergency nurses to care for patients who require an external jugular peripheral intravenous catheter. Key information found in this manuscript includes indications for external jugular intravenous access, the nurse’s role in performing external jugular peripheral intravenous catheters, and clinical considerations when caring for patients with an external jugular peripheral intravenous catheter.

Effects of Exercise on Aortic Stiffness Associated with 5‐Flurouracil in Rats

Background5‐fluorouracil (5‐FU) is a chemotherapy drug that is often prescribed in treatment regimens for malignancies of the gastrointestinal tract, breast, and head/neck. However, despite its clear efficacy in cancer treatment, it is also the second most common chemotherapeutic implicated in the development of short and/or long‐term cardiotoxicity that can lead to a less efficacious cancer treatment regimen. Specifically, 5‐FU is associated with increases in arterial stiffness, leading to increased risks for developing heart failure and cardiovascular disease. Exercise, both acutely and following long‐term training, has exhibited cardiovascular health benefits and protection in healthy and disease populations, including reductions in e.g., pulse wave velocity (PWV), a clinical measure of arterial stiffness. Therefore, the purpose of this study was to investigate 5‐FU induced arterial stiffness (via PWV) and evaluate the efficacy of multiple acute bouts of exercise to mitigate arterial stiffness associated with 5‐FU. Further, we utilized reverse phase protein analysis (RPPA) to investigate mechanisms associated with 5‐FU induced arterial stiffness.MethodsMale Sprague Dawley rats aged 6‐8 months (n=26) were used in this series of experiments. All animals were first acclimated to treadmill exercise, and randomized into four groups: Control (CON, n=8), 5‐FU only (5‐FU=7), exercise (EX, n=4), and 5‐FU with exercise (5‐FUEX, n=7). All animals were surgically instrumented with catheters in the external jugular vein and tail artery. Animals received a clinically relevant dose of 5‐FU with the combination of a bolus (50mg/kg), followed immediately by a 2h continuous infusion of 5‐FU (265mg/kg) through the jugular catheter. This was done to better imitate clinical drug delivery rather than i.p injections typically used in pre‐clinical models. Baseline and 2h measurements of PWV were made from the descending to lower abdominal aorta. Both exercise groups underwent four, 20–30‐minute acute bouts of moderate intensity exercise (20m/min, 5% incline) on consecutive days, 24h apart, with the last being ~10 minutes before surgical instrumentation. RPPA analysis was performed on abdominal aorta from each animal for analysis of changes in protein expression.ResultsThere were no differences in PWV between groups at either time point (p>0.05). However, a significant increase in PWV from baseline to the 2h time point was evident in the 5‐FU group alone (CON ‐1.1±4.9, 5‐FU 14.8±4.4, EX 4.6±5.7, 5‐FUEX 5.4.9±2.2%, p<0.05). Preliminary RPPA analysis indicated 1.5log2fold changes in 5‐FU animals in multiple factors, several of which have been associated with increased vascular stiffness including Steroid Receptor Co‐activator (SRC‐1) and mitogen‐activated protein kinase (MAPK1/MAPK3) that will require further investigation.ConclusionThis study suggests that 5‐FU induces aortic stiffness in rats that can be attenuated with prior acute bouts of exercise. These findings provide further efficacy of exercise therapy in cancer standards of care besides its established benefits for reducing fatigue and improving quality of life in cancer patients. Lastly, the potential to mitigate cardiovascular complications of 5‐FU therapy is clinically important as it can possibly prevent early cessation or reductions of this efficacious therapy.

EP News: Case Reports

In 1960 the first self-powered pacemaker was implanted in a patient. Since that time, the technology has matured and evolved into a common medical therapy used worldwide to treat bradyarrhythmias. McIlraith and Crozier (https://doi.org/10.1016/j.hrcr.2022.02.005) shared what may be the world record of a patient who required continuous permanent pacing. The patient was a 36-year-old man who presented with syncope in second-degree heart block type II with a heart rate of 45 beats/min. In 1969 he received a nonprogrammable mercury-zinc battery powered Teletronics P6 pacemaker with a unipolar lead implanted through the right external jugular vein.

Abstract 473: Cilostazol Decreases Venous Outflow Inflammation And Improves Avf Patency Inmurine Arteriovenous Fistula

Background: Arteriovenous fistula (AVF) have high failure rates, and no pharmacotherapeutics can improve AVF patency. The most common cause of AVF failure is inflammation-driven neointimal hyperplasia and thrombosis. Limited observational data suggests that cilostazol (CIL), an FDA-approved phosphodiesterase-3 inhibitor that inhibits platelet activation and smooth muscle cell proliferation, could help improve AVF maturation. Here, we investigated the effects of cilostazol on murine AVF patency, and further assessed the fibrinogenesis and anti-inflammatory effects using intravital fluorescence molecular imaging. Methods: One week prior to fistula creation, mice were randomized to CIL (40mg/kg/day) or PBS group (n=20 each). AVF was created using an end-to-side external jugular vein and carotid artery anastomosis. AVF blood flow was measured post-operatively (Transonic) and then every 7 days until AVF was occluded (<0.1 ml/min). Macrophages and fibrin were imaged after 10mg/kg FMX-AF555 and/or 4.5nmol FTP11CyAm7 i.v. injection prior to imaging on day 7 or day 14, respectively. The target-to-background ratio (TBR) was calculated as mean signal intensity (MSI) of the fistula divided by the MSI of the contralateral vein. Results: Post-operative AVF blood flow was similar between CIL and PBS treated groups (p=0.3). Average AVF patency was significantly longer in CIL group compared to PBS group (42 vs 21 days, p<0.01, figure 1A). Both day 7 and day 14 venous outflow fibrinogenesis signal assessed by IVM was significantly lower in CIL group compared to PBS group (ps<0.05, Figure 1B). On day 14, CIL significantly lower venous outflow FMX signals compared to PBS group (p<0.05). Conclusion: Oral cilostazol therapy prolongs AVF patency, and decreases venous outflow inflammation and fibrinogenesis in experimental AVF in vivo. The current data supports investigating cilostazol as a clinical pro-AVF patency pharmacotherapeutic strategy in dialysis patients.

Abstract 444: Apolipoprotein A-I (ApoAI) Vascular Gene Therapy Protects Against Vein-Graft Atherosclerosis

Introduction: Coronary artery venous bypass grafts typically fail because of accelerated atherosclerosis, driven by lipid infiltration and by accumulation of macrophages and other cells. We previously showed that transduction of carotid artery endothelium of fat-fed rabbits with a helper-dependent adenovirus expressing apolipoprotein AI (HDAdApoAI) reduced atherosclerotic lesion size and decreased intimal lipid and macrophage accumulation. We hypothesized that HDAdApoAI transduction of rabbit vein graft endothelium would reduce lipid and macrophage accumulation. Methods: Fat-fed rabbits received bilateral external jugular vein to carotid artery interposition grafts. Four wks later, one graft per rabbit was infused with HDAdApoAI and the other with HDAdNull (a non-expressing HDAd). Grafts were harvested 12 wks after HDAd infusion. Paired analysis was performed in all rabbits with bilateral patent grafts (n=22). Graft hemodynamics were measured at vector-infusion and harvest surgeries. In vivo graft diameters were measured before vector infusion and harvest with ultrasound. Grafts were cut into 8 segments, for histology and biochemical analyses. Results: Mean plasma cholesterol levels were 400-600 mg/dL. Graft patency rates were 89% after vein grafting and 100% after the vector-infusion surgery. Lumen diameter and hemodynamics did not differ between HDAdApoAI and HDAdNull-transduced grafts. HDAd genomes were detected in all vein grafts. High levels of apoAI mRNA were detected in 100% of HDAdApoAI-treated vein grafts (mean 155-fold higher than in HDAdNull grafts). HDAdApoAI-treated grafts had 25% lower cholesterol (by mass spectrometry; P=0.03) and 17% less median CD68 mRNA (by RT-qPCR; P=0.008; CD68 is expressed by macrophages and lipid-loaded SMC). No significant differences were detected in mRNA encoding several inflammatory cytokines and inflammation-associated proteins. There were nominal decreases in total intimal area (16%, P=0.9), percent stenosis (4%, P=0.08), and in intimal area positive for Oil Red O (11%, P=0.3), macrophages (11%, P=0.7), and VCAM-1 (8%, P=0.8). Conclusion: HDAdApoAI transduction of vein graft endothelium reduces some markers of atherosclerosis, potentially by stimulating cholesterol efflux.

Defect Coverage after Forequarter Amputation-A Systematic Review Assessing Different Surgical Approaches.

Autologous fillet flaps are a common reconstructive option for large defects after forequarter amputation (FQA) due to advanced local malignancy or trauma. The inclusion of osseous structures into these has several advantages. This article therefore systematically reviews reconstructive options after FQA, using osteomusculocutaneous fillet flaps, with emphasis on personalized surgical technique and outcome. Additionally, we report on a case with an alternative surgical technique, which included targeted muscle reinnervation (TMR) of the flap. Our literature search was conducted in the PubMed and Cochrane databases. Studies that were identified were thoroughly scrutinized with regard to relevance, resulting in the inclusion of four studies (10 cases). FQA was predominantly a consequence of local malignancy. For vascular supply, the brachial artery was predominantly anastomosed to the subclavian artery and the brachial or cephalic vein to the subclavian or external jugular vein. Furthermore, we report on a case of a large osteosarcoma of the humerus. Extended FQA required the use of the forearm for defect coverage and shoulder contour reconstruction. Moreover, we performed TMR. Follow-up showed a satisfactory result and no phantom limb pain. In case of the need for free flap reconstruction after FQA, this review demonstrates the safety and advantage of osteomusculocutaneous fillet flaps. If the inclusion of the elbow joint into the flap is not possible, we recommend the use of the forearm, as described. Additionally, we advocate for the additional implementation of TMR, as it can be performed quickly and is likely to reduce phantom limb and neuroma pain.

Time to Try Something New: Establishing Rat Models of Lung Transplantation Under ECMO Support

<h3>Purpose</h3> Extracorporeal membrane oxygenation (ECMO) has emerged as an important preoperative, perioperative, and postoperative life-support requisite in lung transplantation. Therefore, we aimed to develop rat models of lung transplantation under veno-arterial (VA) and veno-venous (VV) ECMO support. <h3>Methods</h3> Adult male Sprague-Dawley rats weighing 400-450g (recipients, n=10; donors, n=10) were used. The ECMO circuits were initiated by venous drainage from the femoral vein with extracorporeal oxygen exchange and returned to the blood circulation through the right carotid artery (VA-ECMO) or external jugular vein (VV-ECMO). Before ECMO implantation, 5ml heparinized blood from the donor rat was drawn into tubes. Simultaneously, donor lungs were obtained after pulmonary arterial perfusion with low potassium dextran lung preservation solution. ECMO-supported orthotopic left lung transplantation was performed by using cuff technique. Arterial blood gases were measured at designated intervals throughout the experiments. <h3>Results</h3> We found that VA- and VV-ECMO provided sufficient oxygenation to support a smooth left single lung transplantation procedure. The intraoperative hemodynamic and blood gas parameters were maintained stable. <h3>Conclusion</h3> In this study, we first established rat models of lung transplantation under VA and VV ECMO support. This model provides an efficient, economical, and feasible platform for studying lung transplantation with ECMO. This model can be preclinically applied to unravel significant insights in support of further translational models in large animal and human lung transplantation.

Evaluation of the External Jugular Vein Overlying the Sternocleidomastoid Muscle as Venous Lymph-Node Flap.

Background: Until recently, vascularized lymph-node flaps were based on arterial and venous donor vessels. Now, venous lymph-node flaps form a novel promising concept in the treatment of advanced-stage lymphedema. In preliminary studies, the external jugular vein has shown promising results as a venous lymph-node flap. However, nothing is known about the number of lymph nodes adjacent to the external jugular vein. Methods: Standardized specimens of the external jugular vein and surrounding fatty tissue directly overlying the sternocleidomastoid muscle were obtained during routine neck dissection. Histologic evaluation was performed in order to evaluate for the presence of lymph nodes within the tissue. Results: A total of 20 specimens were evaluated. There was no vein in 4 of the samples. We found lymph nodes in 9 of the remaining 16 samples. In 7 samples, lymph nodes were absent. Conclusion: Our results suggest that the vein directly overlying the sternocleidomastoid muscle may not be the ideal candidate for a venous lymph-node flap.

Swine Models of Aneurysmal Diseases for Training and Research.

Large animal models, specifically swine, are widely used to research cardiovascular diseases and therapies, as well as for training purposes. This paper describes two different aneurysmal swine models that may help researchers to study new therapies for aneurysmal diseases. These aneurysmal models are created by surgically adding a pouch of tissue to carotid arteries in swine. When the model is used for research, the pouch must be autologous; for training purposes, a synthetic pouch suffices. First, the right external jugular vein (EJV) and right common carotid artery (CCA) must be surgically exposed. The EJV is ligated and a vein pouch fashioned from a short segment. This pouch is then sutured to an elliptical arteriotomy performed in the CCA. Animals must be kept heparinized during model creation, and local vasodilators may be used to decrease vasospasms. Once the suture is completed, correct blood flow should be inspected, checking for bleeding from the suture line and vessel patency. Finally, the surgical incision is closed by layers and an angiography performed to image the aneurysmal model. A simplification of this aneurysmal carotid model that decreases invasiveness and surgical time is the use of a synthetic, rather than venous, pouch. For this purpose, a pouch is tailored in advance with a segment of a polytetrafluoroethylene (PTFE) prosthesis, one end of which is sutured close using polypropylene vascular suture and sterilized prior to surgery. This "sac" is then attached to an arteriotomy performed in the CCA as described. Although these models do not reproduce many of the physiopathological events related to aneurysm formation, they are hemodynamically similar to the situation found in the clinical setting. Therefore, they can be used for research or training purposes, allowing physicians to learn and practice different endovascular techniques in animal models that are close to the human system.

Intravenous cannula fracture in external jugular vein access: A case report

Cardiovascular Surgery and Interventions publishes original articles on topics in cardiovascular surgery, cardiovascular anesthesia and cardiology. These encompass all relevant clinical, surgical and laboratory studies, editorials, current and collective reviews, technical know-how papers, case reports, interesting images, “How to Do It” papers, correspondence and commentary.

The external jugular vein is a feasible and safe alternative access for retrieval of inferior vena cava filter.

The purpose is to analyze whether the external jugular vein (EJV) is a feasible and safe alternative access for the retrieval IVCFs designed for the jugular approach. This study was designed as a nonrandomized, controlled study. The patients were divided into two groups: the IJV or EJV access groups. All operations were performed by the vascular surgery team. The main outcome was the technical success rate. The secondary outcomes included (1) the IVCF retrieval rate; (2) the time required to puncture the access vein (min); (3) the number of punctures required for access, and other aspects. A total of 119 patients were recruited for IVCF retrieval. Seventeen patients refused to join this trial, leaving 58 patients in the IJV group and 44 patients in the EJV group. In the IJV group, technical success was not achieved in one patient who started in the EJV group and was transferred to the IJV group. There was no significant difference in age, comorbidities, or technical success rate between the two groups. Significant differences were observed in puncture time (min), number of punctures, and inadvertent puncture of the carotid artery. All of the patients were discharged 1 or 2 days after the operation. EJV is safe and feasible alternative access for the retrieval of IVCFs that are designed for jugular approaches.