title: The azygos system as a rare alternative for chronic indwelling catheters placement.
abstract: Chronic indwelling catheters are plagued with a high rate of complications, including infection, central venous occlusion, or thrombosis. When direct access to the superior or inferior vena cava is not possible, venography may identify alternatives that might be viable with current endovascular techniques. This case report describes the successful placement of a tunneled catheter for total parenteral nutrition in the azygos arch through a small collateral vein from the left jugular vein in a patient with no other alternatives because of superior vena cava occlusion and inferior vena cava thrombophlebitis.
authors.affiliation: Cleveland Clinic Foundation Main Campus, Cleveland, Ohio 44125, USA.
authors.forename: Mireille A
authors.initials: MA
authors.lastname: Moise
authors.forename: Neal
authors.initials: N
authors.lastname: Hadro
authors.forename: Hazem
authors.initials: H
authors.lastname: El-Arousy
authors.forename: Javier A
authors.initials: JA
authors.lastname: Alvarez-Tostado
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon; D001401:Azygos Vein / Q000000981:diagnostic imaging; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D002408:Catheters, Indwelling; D006801:Humans; D008297:Male; D010289:Parenteral Nutrition, Total / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D010690:Phlebography; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging / Q000209:etiology*; D013924:Thrombophlebitis / Q000000981:diagnostic imaging / Q000209:etiology*; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging