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Normal venous anatomy and collateral pathways in upper extremity venous thrombosis
H M Richard1, J B Selby, S B Gay
1Department of Radiology, University of Virginia Health Sciences Center, Charlottesville 22908.
Summary
Collateral pathways in arm vein occlusions are not well understood. This study identified neck and chest wall collateral pathways in subclavian and axillary vein occlusions, aiding venogram interpretation.
Area of Science:
- Vascular Medicine
- Radiology
- Anatomy
Background:
- Collateral pathways are documented for superior vena cava occlusion.
- Axillary and subclavian vein occlusions are increasingly common.
- Understanding collateral circulation in upper extremity venous thrombosis is limited.
Purpose of the Study:
- To investigate and describe collateral pathways in cases of axillary or subclavian vein occlusion.
- To enhance the interpretation of upper extremity venograms in patients with venous thrombosis.
Main Methods:
- Retrospective review of 127 arm venograms for suspected venous thrombosis.
- Identification and categorization of 32 cases with subclavian or axillary vein occlusion.
- Analysis of collateral pathway formation and drainage sites.
Main Results:
- Fifteen cases of subclavian vein occlusion showed collateral flow primarily through neck veins.
- Ten cases of axillary vein occlusion demonstrated collateral pathways via the chest wall.
- Seven cases were not definitively categorized regarding occlusion site or collateral pathways.
Conclusions:
- Specific collateral pathways exist for subclavian and axillary vein occlusions, primarily involving neck and chest wall veins.
- Knowledge of these pathways is crucial for accurate interpretation of upper extremity venograms.
- Understanding upper body venous collateralization may improve management of chronic venous diseases and central venous catheter complications.