March 7, 1986

Cannulation of the Right Internal Jugular Vein Is Preferable to That of the Left Internal Jugular Vein

Author Affiliations

University of California, Irvine Medical Center Orange

JAMA. 1986;255(9):1140. doi:10.1001/jama.1986.03370090062020

To the Editor.—  Cannulation of the right internal jugular vein (RIJV) is advantageous when compared with that of the left internal jugular vein (LIJV) in most circumstances.The RIJV is generally larger than the LIJV1 and hence an "easier target." Furthermore, the course of the RIJV is almost parallel to the superior vena cava, and, hence, the catheter easily traverses to the superior vena cava. The LIJV joins the subclavian vein at approximately a right angle so that, while attempting placement, a catheter will at times hit the inferior wall at the origin of the left brachiocephalic vein and then either turn into the left subclavian vein, turn retrograde into the LIJV, or not advance into the left brachiocephalic vein. Sheep and Guiney2 suggest that the circuitous course of the LIJV to the superior vena cava leads to greater contact with the catheter and vessel wall and increases