A pitfall in azygos vein cannulation in cirrhotic patients: mistaken cannulation of the mammary vein.
Azygos venous flow can be measured by a thermodilution catheter in patients with cirrhosis. This is a useful technique since azygos flow is thought to reflect the superior portosystemic collateral flow in these patients. The authors report 3 cases in which mistaken internal mammary vein cannulation mimicked azygos vein cannulation in the supine fluoroscopic view. A lateral fluoroscopic view confirmed internal mammary cannulation. They suggest that if the azygos arch is unpronounced or flow measurements are unexpectedly low in patients with portal hypertension due to cirrhosis, a lateral view be performed to rule out internal mammary vein cannulation.
Lee
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SS
Unite de Recherches de Physiopathologie Hepatique, INSERM U 24, Hopital Beaujon, Clichy, France.
Hadengue
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Braillon
A
A
Lebrec
D
D
D001401:Azygos Vein / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002406:Catheterization, Peripheral; D005471:Fluoroscopy; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011187:Posture; D012039:Regional Blood Flow; D013815:Thermodilution; D013909:Thorax / Q000098:blood supply*; D014680:Veins