ABSTRACT
AIM: To report 11 cases of central venous access catheters migrating from the superior vena cava to the azygos vein in order to raise radiologists' awareness of this possibility. MATERIALS AND METHODS: This is a retrospective review of the clinical history and imaging of 11 patients whose central line migrated from the superior vena cava to the azygos vein. The time course of migration, access route of the catheters, outcome, and depth of placement in the superior vena cava were evaluated. RESULTS: All of these catheters were placed from the left; six through the subclavian vein, four as PICC lines, and one from the left internal jugular vein. Seven of the catheters were originally positioned in the superior vena cava. Four of the catheters were originally positioned in the azygos vein and were repositioned into the superior vena cava at the time of placement. The time to migration ranged from 2 to 126 days, average 43 days. In three cases, the migration was not reported at the first opportunity, resulting in a delay in diagnosis ranging from 10 to 27 days. All but one of the catheters extended at least 3.5 cm (range 1.8-7 cm) below the top of the right mainstem bronchus when in the superior vena cava. CONCLUSION: Risk factors for migration into the azygos vein include placement from a left-sided approach and original positioning in the azygos vein with correction at placement. The depth of placement in the superior vena cava was not a protective factor. It is important to recognize migration because of the elevated risk of complications when central lines are placed in the azygos vein.
Subject(s)
Azygos Vein , Catheterization, Central Venous/instrumentation , Catheters/adverse effects , Foreign-Body Migration/etiology , Vena Cava, Superior , Adult , Aged , Female , Humans , Male , Middle Aged , Retrospective StudiesSubject(s)
Deafness/rehabilitation , Education, Special , Lipreading , Manual Communication , Child , Female , Humans , Male , New York City , Pregnancy , Pregnancy Complications, Infectious , RubellaABSTRACT
A new instrument was designed to measure sex-role bias towards children. The instrument, the Chasen Diagnostic Sex-Role Bias Scale, is composed of case histories focusing on the "somewhat unhealthy" aspects of two main factors of behavior: activity (composed of independence and aggression); and passivity (composed of dependence and nonaggression). Validity and reliability coefficients were reported as well as a formula by which to use the scale to diagnose individual bias, in addition to group bias. In using the scale on a national sample of school psychologists, it was determined that differences in Diagnostic Sex-Role Bias scores exist, as do wide variations about what is considered healthy and unhealthy behavior among girls and boys.
