Variations of the cephalic vein anterior to the clavicle in humans

Kameda, Sadanori; Tanaka, Osamu; Terayama, Hayato; Kanazawa, Takemichi; Sakamoto, Reinii; Tetsu, Shuhei; Sakabe, Kou

doi:10.5603/fm.a2018.0018

Cited by 9 publications

(10 citation statements)

References 16 publications

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“…The EJV has been seen to join with the cephalic vein and lie anterior to the clavicle; in a study of 55 cadavers, between 2 and 5 percent of the cadavers had this structure [8]. These findings are very much similar to the present findings in that the EJV joins with the CV and lies anterior to the clavicle.…”

Section: Aics000534 2(2)2019supporting

confidence: 87%

External Jugular Vein Terminates in Cephalic Vein, an Anatomical Variation During Neck Dissection & its Clinical Impact

Fecik

2019

AICS

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we discovered an unusual unilateral variation in the course of the right EJV, in a 72-year-old female. An iPhone 7 mobile phone was utilized to photograph the case (Figure 1). The following findings were observed: these right-sided vessels appear larger than the left side, the EJV runs over the clavicle & joins the terminal part of the cephalic vein (CV). The transverse cervical vein (TCV) is located superficial to the omohyoid muscle (OH). Deep dissection of axilla shows angiogenesis of axillary vein as the brachial veins continue proximally joining the cephalic vein, large subscapular vein substitutes axillary vein (Figure 2). DiscussionThere have been numerous EJV variations noted in past literature; previous variations observed included abnormalities in both the confluence of the EJV as well as the location

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Section: Aics000534 2(2)2019supporting

confidence: 87%

External Jugular Vein Terminates in Cephalic Vein, an Anatomical Variation During Neck Dissection & its Clinical Impact

Fecik

2019

AICS

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“…Third, and as previously discussed, PPG may remain normal despite positional occlusion of the subclavian vein due to collateral vessels. For example, it has been suggested that 2–5% of patients have a pre-clavicular vein draining blood directly to the jugular vein ( 35 ). Although this may appear to be a limitation of the PPG technique, we believe that, on the contrary, it is of major interest.…”

Section: Discussionmentioning

confidence: 99%

Quantitative analysis of venous outflow with photo-plethysmography in patients with suspected thoracic outlet syndrome

Hersant

Ramondou²,

Josse³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundVenous compression is the second most frequent form of thoracic outlet syndrome (TOS). Although venous photo-plethysmography (PPG) has been largely used to estimate the consequences of chronic thromboses (Paget Schroetter syndrome), systematic direct quantitative recording of hemodynamic consequences of positional venous outflow impairment in patients with suspected TOS has never been reported.ObjectiveWe hypothesized that moving the arms forward (prayer: “Pra” position) while keeping the hands elevated after a surrender/candlestick position (Ca) would allow quantification of 100% upper limb venous emptying (PPGmax) and quantitative evaluation of the emptying observed at the end of the preceding abduction period (End-Ca-PPG), expressed in %PPGmax.Materials and methodsWe measured V-PPG in 424 patients referred for suspected TOS (age 40.9 years old, 68.3% females) and retrieved the results of ultrasound investigation at the venous level. We used receiver operating characteristics curves (ROC) to determine the optimal V-PPG values to be used to predict the presence of a venous compression on ultrasound imaging. Results are reported as a median (25/75 centiles). Statistical significance was based on a two-tailed p < 0.05.ResultsAn End-Ca-PPG value of 87% PPGmax at the end of the “Ca” period is the optimal point to detect an ultrasound-confirmed positional venous compression (area under ROC: 0.589 ± 0.024; p < 0.001). This threshold results in 60.9% sensitivity, 47.6% specificity, 27.3% positive predictive value, 79.0% negative predictive value, and 50.8% overall accuracy.ConclusionV-PPG is not aimed at detecting the presence of a venous compression due to collateral veins potentially normalizing outflow despite subclavicular vein compression during abduction, but we believe that it could be used to strengthen the responsibility of venous compression in upper limb symptoms in TOS-suspected patients, with the possibility of non-invasive, bilateral, recordable measurements of forearm volume that become quantitative with the Ca-Pra maneuver.Clinical trial registration[ClinicalTrials.gov], identifier [NCT04376177].

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“…Shoulder, arm, and head movements are maneuvers that facilitate advancement of the CVC in the shoulder and clavicular region and are associated with temporary changes in positioning of the shoulder and upper limbs, modifying the natural course of the large vessels and facilitating the rectification of probable venous curvatures, promoting the advancement of the catheter to the cavoatrial junction 3,12–16. Knowledge of anatomic variation of the clavicular region and shoulder can facilitate decision making regarding the insertion of a CVC and the use of practices that reduce nonconformity from the procedure 17,18…”

Section: Discussionmentioning

confidence: 99%

“…3,[12][13][14][15][16] Knowledge of anatomic variation of the clavicular region and shoulder can facilitate decision making regarding the insertion of a CVC and the use of practices that reduce nonconformity from the procedure. 17,18 The advancement of the CVC into the thorax is difficult, as described in a study conducted among adults, 19 which may be related to the acute angle at which the cephalic arch joins the axillary vein 4 to the venous plexus that exists between the external jugular vein and above the clavicle. Also challenging are curves 7,19 in the venous stenoses and qualitative studies; level VI, single descriptive studies or qualitative studies; and level VII, evidence from the opinion of authorities and/or the reports of expert committees.…”

Section: Methodsmentioning

confidence: 99%

Maneuvers to Facilitate Central Venous Catheter Advancement in the Clavicular Region

Nobre

Cardoso

Melo

et al. 2022

Journal of Infusion Nursing

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BACKGROUNDThe central venous catheter (CVC) is a vascular access device, inserted by central or peripheral venipuncture, such as the peripherally inserted central catheter, that is frequently used to infuse intravenous solutions and electrolytes, parenteral nutrition, and medications. 1 Difficulty when advancing this kind of catheter can complicate tip positioning during infusion 2 in the right hemiclavicular region 3 or in the clavicular and shoulder regions. 4 Vein variations can cause resistance of catheter advancement. These variations could be congenital or acquired.When vessel distortions are suspected or confirmed, they should be avoided. Caution is required in sites with scar tissue, thoracic tumors, history of repeated catheter insertion, or extended dwell devices, with recommendations to reduce these events. 5 Therefore, applying a body maneuver to facilitate the advancement of the device is important. Maneuvers can be useful, safe, and feasible, contributing to patient safety and risk management 6 because they can facilitate tip positioning in the cavoatrial junction, preventing repeated procedures and enabling safe administration of infusion therapy through the CVCs, decreasing tissue injuries and iatrogenicity. For this reason, when tip placement of a CVC using noninvasive methods is necessary, maneuvering the shoulder 3 has been indicated, with the objective of facilitating the advancement of the CVC into the clavicular/shoulder region. 7 Not every CVC advances after performing some movement; however, several recommendations are made for this purpose, using several maneuvers of the shoulder, head, and neck for catheter advancement in the clavicular/shoulder region in children or adults. There is a need to evaluate the success of the insertion after the application of maneuvers for the advancement of the CVC in adult, pediatric, and neonatal patients. Thus, the research objective of this study was to verify the scientific evidence about maneuvers

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Variations of the cephalic vein anterior to the clavicle in humans

Abstract: Four anatomical variants of the cephalic vein around the clavicle were identified. Clinicians' knowledge of these variants is expected to decrease possible complications if venous access via the cephalic vein is needed.

Cited by 9 publications

References 16 publications

External Jugular Vein Terminates in Cephalic Vein, an Anatomical Variation During Neck Dissection & its Clinical Impact

External Jugular Vein Terminates in Cephalic Vein, an Anatomical Variation During Neck Dissection & its Clinical Impact

Quantitative analysis of venous outflow with photo-plethysmography in patients with suspected thoracic outlet syndrome

Maneuvers to Facilitate Central Venous Catheter Advancement in the Clavicular Region

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