Azigos Vein: Is it a Malposition or an Alternative?

Use of a temporary central venous catheter is common practice in hemodialysis therapy. One of the most common complications of central venous catheterization is catheter malposition. Cannulation of the azygos vein (particularly the azygos arch) is a rare but hazardous catheter malposition that carries a substantial risk of perforation, thrombosis and vascular stenosis. On the other hand, the azygos vein can be used for vascular access in patients whose superior vena cava and inferior vena cava are thrombosed. We present a case where the required blood fl ow for hemodialysis was provided by a dilated azygos vein due to superior vena cava obstruction.