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INFLUENCE OF AGE ON THE ANATOMICAL CHARACTERISTICS OF THE VERTEBRAL ARTERIES: CLINICAL IMPLICATION DURING CENTRAL VENOUS CATHETERIZATION AND NERVE BLOCK
Author(s): ,
Kim, J.T.*
Affiliations:
Seoul National University Hospital, Anesthesiology and Pain Medicine, Seoul, Republic of Korea
,
Lee, J.H.
Affiliations:
Seoul National University Hospital, Anesthesiology and Pain Medicine, Seoul, Republic of Korea
,
Kim, E.H.
Affiliations:
Seoul National University Hospital, Anesthesiology and Pain Medicine, Seoul, Republic of Korea
,
Yoo, S.H.
Affiliations:
Seoul National University Hospital, Anesthesiology and Pain Medicine, Seoul, Republic of Korea
Song, I.K.
Affiliations:
Asan Medical center, Anesthesioilogy and Pain Medicine, Seoul, Republic of Korea
ESRA Academy. Yoo S. Sep 14, 2017; 190825
Topic: ANATOMY
Dr. Seokha Yoo
Dr. Seokha Yoo

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Abstract
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Background and Aims:


To avoid accidental puncture of the vertebral artery (VA) during catheterization of internal jugular vein (IJV) or nerve block, it is important to know the anatomical characteristic of VA. The purpose of this study was to investigate the anatomical characteristics of the VA in infants, children, adolescents, and young adults.

Methods:

Chest CT images of 344 patients were analyzed. We evaluated anatomical characteristics of the right and left VA at the following two levels, the cricoid level and the lower level which was mid-level between the cricoid cartilage and the origin of VA from the subclavian artery.

Results:

The IJV and VA sizes were increased with age. However, relative size of VA to IJV and relative size of VA to CCA decreased with age at both levels (all P<0.001). Right IJV was significantly larger than left IJV whereas there was no difference in VA size between right and left. The relative size of VA to IJV at the right side were significantly smaller than that of the left side at the cricoid level (19.8±13.6% vs 34.5±26.9% respectively, mean difference 14.7±26.8%, P<0.001) and at the lower level (21.6±18.7% vs 36.4±33.7% respectively, mean difference 14.9±38.7%, P<0.001) The VAs overlapped with the IJVs in at least 54% of the patients at the cricoid level and 74% at the lower level.

Conclusions:

The younger children had relatively larger VA compared to IJV and CCA, and shorter distance between VA and IJV. Therefore, we should consider the risk of VA puncture is higher in small children.  

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