PMC6251238_01
A 5-year-old female with Waardenburg syndrome presented for peripherally inserted central catheter placement for total parental nutrition. Digital subtraction venography of the right upper extremity showing chronic total occlusion of the right axillary and subclavian veins (blue arrow).
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F1
Right upper-extremity contrast venography demonstrated chronic total occlusion of the right subclavian vein, likely the result of prior indwelling central venous catheters [Figure 1].
Digital subtraction venography of the left upper extremity showing patient's cephalic arch and subclavian vein draining into a left-sided superior vena cava (red arrow). Left-sided superior vena cava drains to the right atrium via the coronary sinus (blue arrow).
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F2
Left upper-extremity contrast venography was performed [Figure 2], showing a PLSVC draining into the right atrium via the coronary sinus.
Peripherally inserted central catheter line catheter tip (blue arrow) venogram within the coronary sinus (red arrow) showing the right atrium and the main pulmonary artery truck (green arrow).
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F3
The Single-Lumen 3 French PICC was then advanced over the wire and imaged in the coronary sinus before retraction and successful positioning in the left superior vena cava [Figure 3].
Axial contrast-enhanced chest computed tomography showing duplicated superior vena cava (blue and red arrows) and an enlarged pulmonary artery trunk.
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F4
The PLSVC is redemonstrated [Figures 4 and 5].
Coronal contrast-enhanced chest computed tomography showing a left-sided superior vena cava (blue arrow).
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F5
The PLSVC is redemonstrated [Figures 4 and 5].