My Azygous :)

AlmostClever · Post by **AlmostClever** » Sat Jan 29, 2011 5:52 pm

Since we seem to be sharing azy vein venograms, any comments on mine?

Nice and big pic!

Cece · Post by **Cece** » Sat Jan 29, 2011 6:35 pm

How can you tell if an image is perpendicular to the arch or not...

Anyway did the IR say your azygous was normal?

I think if an azygous is in an MS patient, odds are it's not normal!

AlmostClever · Post by **AlmostClever** » Sat Jan 29, 2011 6:45 pm

This is from Albany so I'm assuming it's a perp. image.

It was balloned in 3 spots around the arch but the follow-up dye injection doesn't reveal much on the image sequence I received.

Since my jugular restenosed, I'm thinking my azy might have also restenosed/recoiled. I do not remember the balloon size used but I am sure they were not oversized like those used in Sinan's procedure.

Also, there's no clear image of the entry point into the heart. I assume there's a valve there but is this a valve that you want to destroy?

A/C

Nunzio · Post by **Nunzio** » Mon Jan 31, 2011 3:48 am

Cece wrote:How can you tell if an image is perpendicular to the arch or not...

There are 2 ways:
1: look at the upper angle formed by the catheter; the more acute the further away from perpendicular you are, the smoother angle (obtuse) you see the closer to 90% you are.
2: look at the relative distance from the posterior Azygous to the anterior (SVC). the further apart they are the closer to perpendicular you are.
see the picture below and you can decide which is which.

Nunzio wrote:
Rokkit wrote:

AlmostClever · Post by **AlmostClever** » Mon Jan 31, 2011 7:28 am

I always assumed the IR's took perpendicular images but I realize that may not always be easily done! My image seems to be somewhere close - the bend of the wire appears to be more obtuse, right?

Any comment on the collaterals? I haven't seen this in any other images... Why would these form without obstruction downstream?

After reading Nunzio's response on Rokkit's image, I went back and looked at the study to see if my dye pattern was similar as it approached the SVC confluens - hard to be sure but there was a slight similarity.