[Digital subtraction angiography as an aid in decision-making in problematic approaches to the superior vena cava]

By digital subtraction angiography (DSA), diagnostic statements can be made even with low concentrations of contrast medium. Despite the increasing dilution of contrast medium, a definite statement on mediastinal vessel condition is possible in direct visualisation of the arm veins up to the vena cava superior as well as of collaterals using peripheral injection of the contrast medium. Two case histories show that the investigator has definite criteria at his disposal enabling him to forgo frustrating puncture attempts in the area of the vena subclavia, vena jugularis interna and vena anonyma in case of suspected thrombotic vessel closure after long-term parenteral nutrition.