title: Cardiac veins: collateral venous drainage pathways in chronic hemodialysis patients.
abstract: Venous anomalies are diagnostic and therapeutic challenges. Subclavian or superior vena cava stenosis can be developed and venous return can be achieved via cardiac veins and coronary sinus in patients with central venous catheter for long-term hemodialysis. These types of abnormalities are not extremely rare especially in patients with a history of central venous catheter placement. Detection of these anomalies and subclavian vein stenosis before the surgical creation of hemodialysis fistulae or tunneled central venous catheter placement may prevent unnecessary interventions in those patients. Multidetector computed tomography (MDCT) technique can give further information when compared with fluoroscopy or digital subtraction angiography in the management of these patients. This case report describes interesting aspects of central vein complications in hemodialysis patients. As a conclusion, there are limited data about thoracic venous return, and further prospective studies with large patient number are required. MDCT with 3D reconstruction is particularly useful for the accurate evaluation of venous patency, variations, and collateral circulation. Also it is an excellent tool for choosing and planning treatment.
authors.affiliation: Department of Radiology, Ataturk Training and Research Hospital, Ankara - Turkey.
authors.forename: Evrim
authors.initials: E
authors.lastname: Ozmen
authors.affiliation: Department of Radiology, Ataturk Training and Research Hospital, Ankara - Turkey.
authors.forename: Oktay
authors.initials: O
authors.lastname: Algin
mesh_terms: D016121:Brachiocephalic Veins / Q000000981:diagnostic imaging / Q000503:physiopathology; D002405:Catheterization, Central Venous / Q000009:adverse effects; D003097:Collateral Circulation; D000072226:Computed Tomography Angiography; D003251:Constriction, Pathologic; D017023:Coronary Angiography / Q000379:methods; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging / Q000503:physiopathology; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D010690:Phlebography / Q000379:methods; D012039:Regional Blood Flow; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013350:Subclavian Vein / Q000000981:diagnostic imaging / Q000503:physiopathology; D014652:Vascular Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014654:Vascular Patency