title: Fluoroscopic landmark for SVC-RA junction for central venous catheter placement in children.
abstract: BACKGROUND
  Vascular access devices are commonly placed under image guidance. The usual aim is to place the tip at the superior vena cava-right atrial junction (SVC-RA).
  
  
  OBJECTIVE
  To identify a radiographic landmark for the SVC-RA junction that would be useful for accurate central venous catheter tip placement in children.
  
  
  METHODS
  Images from 56 children undergoing contrast studies of their upper limb venous systems were examined for location of the SVC-RA in relation to a radiographic landmark.
  
  
  RESULTS
  Most patients (92.5%) showed the SVC-RA junction to lie at the sixth thoracic vertebral level or the interspace above or below. The SVC-RA junction lay lower than the right main bronchus and the notch on the right cardiomediastinal contour.
  
  
  CONCLUSIONS
  The vertebral body provides a useful and radiographically visible landmark for accurate central catheter tip placement.
authors.affiliation: Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada. bairbre.connolly@sickkids.on.ca
authors.forename: B
authors.initials: B
authors.lastname: Connolly
authors.forename: J B
authors.initials: JB
authors.lastname: Mawson
authors.forename: C E
authors.initials: CE
authors.lastname: MacDonald
authors.forename: P
authors.initials: P
authors.lastname: Chait
authors.forename: H
authors.initials: H
authors.lastname: Mikailian
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000790:Angiocardiography; D015901:Angiography, Digital Subtraction; D002405:Catheterization, Central Venous; D002648:Child; D002675:Child, Preschool; D002932:Cineangiography; D005471:Fluoroscopy; D006801:Humans; D007223:Infant; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging*