Posterior Intercostal Veins Research Articles

The second and third right posterior intercostal veins: an alternate route for central venous access with an implantable port in children

Background/Purpose Some children dependent on total parenteral nutrition for long periods have no more axillary, internal jugular, external jugular, saphenous, and femoral veins available for cannulation. In such patients, the central venous system can still be accessed via the azygos vein by placing an implantable port catheter through one of the right posterior intercostal veins. This is the first known description of such procedure. Methods We report the use of the second and third right intercostal veins for placement of the catheter by right intrapleural thoracotomy in 2 pediatric patients with short gut syndrome. Results Recovery from the thoracotomy was uncomplicated, and the patients could receive complete intravenous nutritive mixtures immediately after the insertion of the catheter. Both patients remain dependent on total parenteral nutrition and are awaiting an intestinal transplantation. Conclusion The knowledge of alternate routes to obtain central venous access for prolonged parenteral nutrition is critically important, and the azygos system can be used when more accessible veins are unavailable.

Spiral CT study of superior vena cava syndrome: correlation between collateral pathways and obstruction site and degree

To study the collateral pathways of superior vena cava syndrome ( SVCS) . Thirty-one spiral CT phlebograms of patients with SVCS were obtained. Superior vena cava was divided into upper and lower segment by azygos arch, and the collateral pathways were divided into anterior and posterior groups according to their sites in the chest wall. The distribution of collateral pathways and obstruction site and degree of SVC were observed and analysed statistically . The drainage of SVCS was determined. Anterior group of collateral pathways, vertebral venous plexus and posterior intercostal veins were related to obstruction of upper segment of SVC ( P < 0. 05) . Obstruction of the lower part of SVC has relation to the hemiazygos vein ( P < 0. 05) . The correlation between obstructive degree and distribution of collateral pathways was not distinct in this study ( P > 0. 05) . When obstruction of upper segment of SVC occurred, blood could return to heart through azygos vein or anterior group vessels. While lower segment of SVC was occluded, blood could reflux through azygos vein and hemiazygos vein to right atrium. Distribution of collateral pathways in SVCS is closely related to the obstruction site of SVC, but not to the degree of obstruction.