CTICasesSuperior Vena Cava Syndrome with Vasa Vasorum Collateralization
Imaging findings
CT in a sickle cell patient shows thrombosis of the left brachiocephalic vein extending into the superior vena cava (SVC). This has resulted in SVC syndrome with exuberant systemic collateralization, including dilated collateral vessels running along the wall of the aorta (representing dilated vasa vasorum) and tracking along the atrioventricular groove.
Key takeaways
SVC obstruction leads to the development of extensive collateral pathways to return blood to the right atrium. In chronic occlusion, very unusual collateral pathways can develop, including dilation of the aortic vasa vasorum and coronary collateral channels, which can mimic vascular calcification on suboptimally timed contrasted scans.
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