Thrombosis of noncatheterized internal jugular vein: a unique complication of subclavian catheterization diagnosed by ultrasound.

Using portable high-resolution real-time B-mode ultrasound, the authors observed the phenomenon of thrombosed internal jugular vein in four patients who had prolonged indwelling ipsilateral subclavian catheters with or without catheterized subclavian vein thrombosis. Of these, thrombosed internal jugular vein was found incidentally in three patients with no specific findings suggestive of this complication.The origin of this uncommon complication is thought to be flow stasis in the internal jugular vein due to multiple factors associated particularly with turbulence at the jugulo-subclavian junction and the effect of hyperosmolar solution on blood cells. Treatment consists of removal of the catheters and heparinization when indicated. The authors recommend high-resolution ultrasound in the detection and follow-up of this unusual complication.