At what level is the arch of the azygous (azygous vein) vein located?

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Last updated: June 13, 2025View editorial policy

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From the Research

The arch of the azygos vein is located at the level of the fifth thoracic vertebra (T5). This important venous structure curves over the right main bronchus at the root of the right lung before emptying into the superior vena cava. The azygos vein serves as a vital collateral pathway between the superior and inferior vena cava, collecting blood from the posterior thoracic and abdominal walls. Its arch is a key anatomical landmark during thoracic procedures and can be visualized on chest imaging.

Key Points

  • The position at T5 places it in the superior mediastinum, making it an important consideration during surgical approaches to this region.
  • The arch's location is clinically significant as it can be dilated in conditions causing increased central venous pressure, and its identification is essential during right-sided thoracic surgeries to avoid vascular complications.
  • According to the study by 1, the arching and opening level of the AV was at the fifth thoracic vertebra in most cases, which supports the location of the arch of the azygos vein at T5.
  • Other studies, such as 2, 3, and 4, provide information on the migration of central lines and the importance of correct placement, but do not specifically address the location of the arch of the azygos vein.
  • The most recent study, 3, published in 2024, describes a case of intraoperative detection of a central venous catheter in the azygos vein arch during esophageal cancer surgery, but does not provide information on the typical location of the arch.
  • Therefore, based on the available evidence, the arch of the azygos vein is located at the level of the fifth thoracic vertebra (T5), as supported by the study by 1.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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