Percutaneous ultrasound-guided central venous catheters : the lateral in-plane technique for internal jugular vein access

Purpose: To describe the possible ultrasound guidance techniques for the insertion of central venous catheters (CVCs), with emphasis particularly to the lateral short axis in-plane technique. Methods: Numerous articles have shown significant benefits of using ultrasound guidance for venous access. Two main approaches to vein puncture are available, when considering visualization of the needle during its entry into the vein under the ultrasound beam: in-plane and out-of-plane, which can be combined with two types of vein visualization, placing the ultrasound probe on the vein long axis or short axis. Results: Advantages and limitations in internal jugular vein (IJV) cannulation for long-term dialysis CVCs are described for the above-mentioned approaches and visualizations. The lateral short axis in-plane technique has virtually no limitations, ensuring most benefits. Conclusions: The lateral short axis in-plane technique should be considered the first-line technique for IJV cannulation.