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Anatomy of veins and lymphatics
Published in Ken Myers, Paul Hannah, Marcus Cremonese, Lourens Bester, Phil Bekhor, Attilio Cavezzi, Marianne de Maeseneer, Greg Goodman, David Jenkins, Herman Lee, Adrian Lim, David Mitchell, Nick Morrison, Andrew Nicolaides, Hugo Partsch, Tony Penington, Neil Piller, Stefania Roberts, Greg Seeley, Paul Thibault, Steve Yelland, Manual of Venous and Lymphatic Diseases, 2017
Ken Myers, Paul Hannah, Marcus Cremonese, Lourens Bester, Phil Bekhor, Attilio Cavezzi, Marianne de Maeseneer, Greg Goodman, David Jenkins, Herman Lee, Adrian Lim, David Mitchell, Nick Morrison, Andrew Nicolaides, Hugo Partsch, Tony Penington, Neil Piller, Stefania Roberts, Greg Seeley, Paul Thibault, Steve Yelland
The hemiazygos vein usually continues from the left ascending lumbar vein, and passes up through the left crus of the diaphragm to ascend on the left side of the vertebral column. It passes to the right across the vertebral column behind the aorta, oesophagus and thoracic duct at about the level of the ninth thoracic vertebra, to end in the azygos vein. The hemiazygos vein may be connected above to the accessory hemiazygos vein, the two of them being a mirror of the azygos vein on the right side.
Development and anatomy of the venous system
Published in Peter Gloviczki, Michael C. Dalsing, Bo Eklöf, Fedor Lurie, Thomas W. Wakefield, Monika L. Gloviczki, Handbook of Venous and Lymphatic Disorders, 2017
The origin of the azygos vein is not constant. It may arise from the back of the inferior vena cava at the level of the renal veins or it may be the continuation of the right ascending lumbar vein (Figure 2.11). The azygos vein ascends on the right side of the body until the fourth thoracic vertebra and then passes anteriorly to join the superior vena cava. Major tributaries of the azygos vein are the right superior intercostal, the hemiazygos, and the accessory hemiazygos veins. The hemiazygos vein courses on the left side of the vertebral column and its origin is similar to that of the azygos vein. At the level of the eighth thoracic vertebra, it crosses the column and joins the azygos vein. Often, the left renal vein communicates with the hemiazygos vein. The accessory hemiazygos vein descends left to the vertebral column and parallel with the azygos vein. Proximally, it anastomoses with the left brachiocephalic vein and ends distally when it joins to the azygos or the hemiazygos veins at the level of the seventh thoracic vertebra. The azygos veins drain the intercostal veins on both sides, receive several visceral tributaries, and freely anastomose with the vertebral venous plexuses. The azygos veins and their tributaries provide important collateral circulation in the face of superior or inferior vena cava obstruction.
The Governor Vessel (GV)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
An accessory hemiazygous vein assists the hemiazygous vein in draining structures on the left side. The accessory hemiazogous vein receives tributaries from the 4th through the 8th intercostal veins, and occasionally from the left bronchial veins. The azygous and hemiazygous veins provide one of the main avenues through which venous drainage from the thorax, abdomen, and back can continue in the face of caval obstruction, due to their extensive communications with the superior and inferior venae cavae, ascending lumbar veins, and many tributaries of the inferior vena cava.
Insertion of a totally implantable venous access port in a patient with persistent left superior vena cava (PLSVC)
Published in Acta Chirurgica Belgica, 2018
Julie Van Walleghem, Sofie Depuydt, Stijn Schepers
Persistent left superior vena cava (PLSVC) is the most common embryological malformation of the central venous system, reported in 0.3–0.5% of the general population [1]. Usually a PLSVC is asymptomatic and an incidental finding during placement of a central venous access device; however, patients are at increased risk of developing cardiac arrhythmias, due to the associated anomalous configuration of the embryological conductive tissue. Given the aging patient population and growing use of central venous access devices, physicians will be increasingly confronted with anatomical variations of the cardiac venous return. The existence of a PLSVC is suggested by periprocedural fluoroscopy that shows a left paramediastinal guidewire pathway after an uncomplicated venous puncture, nonetheless the presence of a large left superior intercostal vein, accessory hemiazygos vein, internal mammary vein or the occurrence of a venous perforation can lead to a similar finding.