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Computed tomography angiography study of the azygos vein course and termination into superior vena cava: gender and age impact

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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.

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Authors and Affiliations

  1. Department of Anatomy and Surgical Anatomy, Medical School, Faculty Health and Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Konstantinos Koutsouflianiotis, Georgios Paraskevas, Chrysanthos Chrysanthou & Konstantinos Natsis

  2. Department of Radiology, General Hospital of Thessaloniki “G.Gennimatas”, Thessaloniki, Greece

    Georgios Daniil

  3. Department of Anatomy, Medical School, Faculty of Health and Sciences, National and Kapodistrian University of Athens, Athens, Greece

    Maria Piagkou

Authors
  1. Konstantinos Koutsouflianiotis
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  2. Georgios Daniil
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  3. Georgios Paraskevas
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  4. Maria Piagkou
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  5. Chrysanthos Chrysanthou
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  6. Konstantinos Natsis
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Contributions

KN made the project of the study, revised the paper contributed to the statistical analysis and made the proofs correction, KK and MP searched the data literature, wrote and edited the paper and made the statistical analysis, GD performed the vessels’ measurements and collected all data patients, CC and GP have edited the paper. All authors have approved the submitted draft.

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Correspondence to Konstantinos Koutsouflianiotis.

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Koutsouflianiotis, K., Daniil, G., Paraskevas, G. et al. Computed tomography angiography study of the azygos vein course and termination into superior vena cava: gender and age impact. Surg Radiol Anat 43, 353–361 (2021). https://doi.org/10.1007/s00276-020-02583-8

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  • DOI: https://doi.org/10.1007/s00276-020-02583-8

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