Clinical studyCT Angiography of the Superior Vena Cava: Normative Values and Implications for Central Venous Catheter Position
Section snippets
Materials and Methods
This retrospective study was approved by the institutional review board and included a waiver of informed consent. We reviewed 112 pulmonary CT angiograms obtained during maximal inspiration in 56 men and 56 women who were suspected of having acute pulmonary embolism at a single non-profit Health Maintenance Organization hospital. All studies were performed with a four-section CT unit (Lightspeed QXi; GE Medical Systems, Milwaukee, Wis) by using 1.25-mm collimation after the intravenous
Results
The Table presents the data about the length of the SVC and the distances from the right tracheobronchial angle and the carina to the top of the SVC and the cavoatrial junction.
The mean length of the SVC (±standard deviation) was 70.7 mm ± 14.1 (range, 45–117 mm; 95% confidence interval [CI]: 68.1 mm, 73.4 mm). There was a statistically significant difference in the length of the SVC between men and women (75.2 mm ± 15.3 vs 66.2 mm ± 11.2, respectively; P < .001). Multivariate linear regression
Discussion
Optimal positioning of central venous catheters is a complex issue. Historically, radiographs have been used to evaluate for proper placement of central venous catheters on the basis of radiographic landmarks including the right tracheobrochial angle (4, 8), cardiac silhouette (9), and carina (10, 11).
Little normative data exist about the relationships between frequently used anatomic landmarks and the superior and inferior borders of the SVC. Data obtained from MR images or CT scans of
References (12)
Central venous catheter tip position: a continuing controversy
J Vasc Interv Radiol
(2003)- et al.
MRI of central venous anatomy: implications for central venous catheter insertion
Chest
(1998) - et al.
Cardiac tamponade from central venous catheters
Am J Surg
(1998) - et al.
The carina as a landmark in central venous catheter placement
Br J Anaesth
(2000) - et al.
Applied anatomy of the superior vena cava: the carina as a landmark to guide central venous catheter placement
Br J Anaesth
(2004) Precautions necessary with central venous catheters
Cited by (49)
Ultrasound Imaging of the Superior Vena Cava: A State-of-the-Art Review
2023, Journal of the American Society of EchocardiographyThree simple but interesting transthoracic echocardiographic road maps for proximal superior vena cava visualisation in healthy young adults
2022, IJC Heart and VasculatureCitation Excerpt :They have suggested a normal range for the major axis (1.5–2.8 cm) and minor axis (1–2.4 cm). Mahlon and Yong [17] have shown the mean length of the SVC to be 7.1 ± 1.4 cm, and its maximum diameter in adults to be 2.1 ± 0.7 cm by SVC CT-angiography. In addition, although SVC-MR venography has been reported for a variety of SVC problems, no data regarding its dimensions could be found in the literature [18,19].
Saccular Superior Vena Cava Aneurysm: Case Report and Comprehensive Review
2021, Annals of Vascular SurgeryCitation Excerpt :It courses along the right middle mediastinum, with the trachea and ascending aorta on its left, and drains into the right atrium. Image studies have demonstrated that its mean length is 7.1 cm ± 1.4, and its maximum diameter in adults is 2.1 cm ± 0.7.2 Congenital variants of the SVC can be incidental and may be associated with cardiac anomalies or syndromes.
Lead-related superior vena cava syndrome: Management and outcomes
2021, Heart RhythmShanghai expert consensus on totally implantable access ports 2019
2019, Journal of Interventional MedicineDesign and simulation of pulsatile blood flow energy harvester for powering medical devices
2019, Microelectronics Journal
The views expressed herein are those of the authors and do not reflect the official policy of the Department of the Army, Department of Defense, or the U.S. Government.
None of the authors have identified a conflict of interest.