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- W1989251635 abstract "Sir—We read with interest the recently published pictorial review by Burney et al. 1 Burney K. Young H. Barnard S. et al. CT appearances of congenital and acquired abnormalities of the superior vena cava. Clin Radiol. 2007; 62: 837-842 Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar The authors point out that the hemiazygos–azygos system is quite variable in terms of anatomical course and drainage pattern, as we indeed experienced in a recent case in our department. A renal patient had a permanent central catheter inserted without radiological guidance. Access was gained via the left internal jugular vein. The insertion went smoothly but afterwards blood could not be aspirated from the line. A frontal chest radiograph was obtained in the first instance and showed the catheter tip projected to the left of the vertebral column. A CT examination followed by a venogram revealed the catheter position to be in the accessory hemiazygos vein, most likely via the superior intercostal vein, which can communicate with the accessory hemiazygos(Figure 1, Figure 2). The catheter was re-positioned under radiological guidance. The patient remained well throughout. The accessory hemiazygos vein usually descends on the left side of the vertebral coloumn, receives the fourth to the eighth left intercostals veins, and crosses the body of the seventh thoracic vertebra to join the azygos vein. Sometimes the accessory hemiazygos vein may drain either directly or after forming a common trunk with the left superior intercostal vein into the left brachiocephalic vein. 2 Muhm M. Sunder-Plassmann G. Druml W. Malposition of a dialysis catheter in the accessory hemiazygos vein. Anesth Analg. 1996; 83: 883-885 PubMed Google Scholar Figure 2Contrast-enhanced CT image with axial multiplanar reconstruction shows the tip of the central line in the superior intercostal/accessory hemiazygos system, which follows a posterior course. View Large Image Figure Viewer Download Hi-res image" @default.
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- W1989251635 date "2008-07-01" @default.
- W1989251635 modified "2023-10-18" @default.
- W1989251635 title "RE: CT appearances of congenital and acquired abnormalities of the superior vena cava" @default.
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- W1989251635 doi "https://doi.org/10.1016/j.crad.2008.01.013" @default.
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