Diversion of venous blood flow through transverse sinuses in one-sided innominate vein obstruction.

The literature contains many reports of superior vena cava obstruction (1) but few of one-sided innominate vein obstruction with the superior vena cava remaining patent. Such reports of innominate vein obstruction as have appeared deal mainly with the clinical findings, without demonstration by phlebography of all possible routes of blood-flow diversion from the affected area (2, 3). As far as we could ascertain, the case to be reported here is the first in which the transverse sinuses were demonstrated by the injection of contrast medium into the cubital vein. It came to our attention in the course of angiography for the diagnosis of mediastinal lesions. S. K., a 30-year-old male, two years before admission to our hospital noticed swelling of his face and both arms, and a mass above the left clavicle, the size of a hen's egg. A diagnosis of Hodgkin's disease had been made at that time (Fig. 1). After x-ray therapy the supraclavicular mass and the swelling of the face disappeared, and the patient felt wel...