Internal jugular vein puncture placement can rapidly open jugular vein access, which is usually used for resuscitation treatment such as infusion and blood transfusion, and also used for long-term chemotherapy patients, which can effectively protect the peripheral vasculature. Clinically, according to the patient’s condition and the doctor’s operating experience, there are three common puncture points for internal jugular vein puncture, which can be divided into anterior, middle and posterior routes. 1. anterior route: the index and middle fingers of the operator’s left hand are placed at the midpoint of the sternocleidomastoid muscle, while the lateral aspect of the common carotid artery pulsation can be touched, the puncture needle points to the ipsilateral papilla, the puncture needle makes an angle of 30°-45° with the coronal surface, and is punctured at the anterior edge of the midpoint of the sternocleidomastoid muscle The needle tip is pointed at an angle of 30°-40° with the skin, and the needle tip is pointed at the ipsilateral papilla, and the puncture is 2-3 cm into the internal jugular vein. 3. Posterior approach: the needle is often inserted at the middle and lower 1/3 of the lateral border of the sternocleidomastoid muscle, about 5 cm above the clavicle The tip of the needle is kept horizontal and pierced deep in the clavicular head of the sternocleidomastoid muscle, pointing to the superior sternal notch. These are the three commonly used approaches in clinical practice, and some physicians also use the triple designation approach to perform internal jugular vein puncture. The plane of the thyroid cartilage can be determined first, and the intersection of the horizontal line of this plane and the midpoint of the sternocleidomastoid muscle is the point of entry, and the tip of the needle points to the midpoint of the clavicle or the nipple before entering the needle. It is possible to establish the venous access by making sure that the guidewire is correctly positioned under DSA fluoroscopy.