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Original Research



Vertebral levels of great vessels in mediastinum and their role in vascular interventions

Naziya P Syed, Althaf S Ali, Imran S Syed, Pritha SS Bhuiyan.




Abstract

Background: The interventional procedures such as central venous catheterization demand better knowledge of anatomy of mediastinal vessels. The vertebral body provides a useful and radiographically visible landmark for accurate central catheter tip placement.

Objective: To study the vertebral levels of formation and termination of superior vena cava (SVC) and the vertebral level of origin of brachiocephalic trunk, left common carotid artery, and left subclavian artery in Indian subjects, and to describe their role in vascular interventions.

Materials and Methods: The CT chest images of 48 patients were studied and vertebral levels of earlier mentioned vessels were measured.

Results: The vertebral level of formation of SVC was found to be at the level of T3, T4, and T5 in 22.91%, 62.50%, and 14.58% cases, respectively, whereas that of the termination of SVC was found to be at the level of T5, T6, T7, and T8 in 10.41%, 56.25%, 29.16%, and 4.16% cases, respectively. The left common carotid artery, left subclavian artery, and the brachiocephalic trunk were found at T3, T4, and T5 in 27.08%, 60.41%, and 12.50% cases, respectively.

Conclusion: The comprehensive data of vertebral levels will help clinicians in understanding the vascular levels for diagnostic and therapeutic purposes, especially in Indian subjects.

Key words: Superior vena cava, central venous catheter, catheter tip placement, mediastinal vasculature, Indian subjects






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