Computed tomography angiography study of the azygos vein course and termination into superior vena cava: gender and age
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ORIGINAL ARTICLE
Computed tomography angiography study of the azygos vein course and termination into superior vena cava: gender and age impact Konstantinos Koutsouflianiotis1 · Georgios Daniil2 · Georgios Paraskevas1 · Maria Piagkou3 · Chrysanthos Chrysanthou1 · Konstantinos Natsis1 Received: 28 March 2020 / Accepted: 16 September 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Purpose The study highlights azygos vein (AV) topography, arrangement and confluence morphometry in dyspnoea and tachycardia patients of extrapulmonary and extracardiac aetiology. Method Computed-tomography angiography of 25 male and 26 female patients (mean age 66.5 years) were studied for: thoracic vertebral (T) height of AV- superior vena cava-SVC confluence, AV course and deviations from vertebral column (VC) midline, AV and SVC diameters, distance (AV arch- lower border of carina) and gender and age impact. Results Commonest heights of the AV-SVC confluence were T5 (56.9%), T4 (31.4%), T6 (9.8%) and T3 (2%). The AV terminated into SVC after crossing the left side of VC midline in 56.9%, slightly deviated right of the midline in 37.3% and coursed right of VC in 5.9%. Mean AV and SVC diameters were 0.96 ± 0.18 cm and 1.86 ± 0.27 cm. Male predominance in AV and SVC diameters and a slight AV diameter significant increase with the age were found. The (AV highest point—lower border of carina) mean distance was 2.05 ± 0.44 cm and male predominance existed. Conclusion The commonest termination height of the AV was T5, while T3 was the rarest one. Aging induces the AV leftward displacement, while gender had no impact. AV and SVC diameters had higher significant values in males, while ageing had a significant impact only in AV diameter. The AV higher diameters will be used as predictors for higher values of SVC diameter and mediastinum pathology. Such findings can be useful in mediastinal surgery, mediastinoscopy and surgery of VC deformations, neurovascular surgery of retroperitoneal organs, disc herniation and T fractures. Keywords Azygos vein · Anatomy · Variation · Computed tomography angiography · Morphometry
Introduction The azygos vein (AV) typically ascends posterior mediastinum along thoracic vertebrae (T) anterolateral surface, after coursing through the diaphragm and terminates at T4, arching anteriorly (the so-called AV arch) to superior vena cava (SVC) [30], close to the 2nd costal cartilage * Konstantinos Koutsouflianiotis [email protected] 1
Department of Anatomy and Surgical Anatomy, Medical School, Faculty Health and Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
2
Department of Radiology, General Hospital of Thessaloniki “G.Gennimatas”, Thessaloniki, Greece
3
Department of Anatomy, Medical School, Faculty of Health and Sciences, National and Kapodistrian University of Athens, Athens, Greece
(± 16.3 mm rightward) of vertebral column (VC) midline [21]. Rarely, the AV drains into the right brachiocephalic vein, the right subclavian vein, the intrapericardial SVC an
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