Fluoroscopic landmark for SVC-RA junction for central venous catheter placement in children

Background. Vascular access devices are commonly placed under image guidanc e. The usual aim is to place the tip at the superior vena cava-right atrial juntion (SVC-RA), Objective. To identify a radiographic landmark for the SVC-RA junction that would be useful for accurate central venous catheter tip placement in chil dren. Materials and methods. Images from 56 children undergoing contrast studies of their upper limb venous systems were examined for location of the SVC-RA in relation to a radiographic landmark. Results. Most patients (92.5%) showed the SVC-RA junction to lie at the six th thoracic vertebral level or the interspace above or below. The SVC-RA ju nction lay lower than the right main bronchus and the notch on the right ca rdiome-diastinal contour. Conclusion. The vertebral body provides a useful and radiographically visib le landmark for accurate central catheter tip placement.