title: Superior vena cava syndrome associated with right-to-left shunt through systemic-to-pulmonary venous collaterals.
abstract: Superior vena cava (SVC) obstruction is associated with the gradual development of venous collaterals. We present a rare form of systemic-to-pulmonary subpleural collateral pathway that developed in the bridging subpleural pulmonary veins in a 54-year-old woman with complete SVC obstruction. This uncommon collateral pathway represents a rare form of acquired right-to-left shunt due to previous pleural adhesions with an increased risk of stroke due to right-to-left venous shunting, which requires lifelong anticoagulation.
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. ; Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan 333, Taiwan.
authors.forename: Yu-Hsiang
authors.initials: YH
authors.lastname: Juan
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Sachin S
authors.initials: SS
authors.lastname: Saboo
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Vishal
authors.initials: V
authors.lastname: Anand
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. ; Cardiology Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Yiannis S
authors.initials: YS
authors.lastname: Chatzizisis
authors.affiliation: Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung and Chang Gung University, Keelung 204, Taiwan.
authors.forename: Yu-Ching
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Steigner
mesh_terms: D003097:Collateral Circulation / Q000502:physiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D010690:Phlebography / Q000379:methods; D011667:Pulmonary Veins / Q000000981:diagnostic imaging* / Q000503:physiopathology; D020521:Stroke / Q000150:complications; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014680:Veins / Q000503:physiopathology
keywords: Computed tomography; Pulmonary venous collaterals; Superior vena cava syndrome