Which vessels are vulnerable to damage with insertion of a percutaneous tracheostomy?

  • Anterior jugular veins 1:
    • Run vertically close to the midline
  • Thyroid ima artery 1:
    • Ima is ‘lowest’ in Latin
    • Anatomical variant in 3–10% of the population
    • More common British Asian populations
    • Arises mainly from the brachiocephalic trunk and ascends along the front of the trachea
  • Inferior thyroid veins 1
  • Other vessels more lateral: internal jugular vein, carotid artery, external jugular vein