Vascular pedicle

Last revised by Patrick O'Shea on 29 Dec 2023

Vascular pedicle is bordered on the right by venous structures (right brachiocephalic vein above and superior vena cava) and on the left by an arterial structure (the left subclavian artery origin). The azygos vein (black oval) is seen en face above the right main bronchus.

The vascular pedicle width can help to differentiate different causes of pulmonary edema:

  • normal or narrowed: increased capillary permeability e.g. sepsis

  • normal: acute cardiac failure

  • wide: fluid overload e.g. renal failure, chronic heart failure

Radiographic features

Plain radiograph

The vascular pedicle width (VPW) is the distance between parallel lines drawn from the point at which the superior vena cava intersects the right main bronchus and a line drawn at the takeoff of the left subclavian artery from the aorta. The mean vascular pedicle width is 38-58 mm on posteroanterior chest radiographs.

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