Double axillary vein variation diagnosed with ultrasound guidance during infraclavicular nerve block intervention

Abstract

The use of ultrasound guidance increases the safety of peripheral block interventions by allowing anaesthesiologists to simultaneously see the position of block needle, the targeted nerves and surrounding vessels. In this report, we represented three patients diagnosed with double axillary vein variation with ultrasound guidance during infraclavicular nerve block intervention. The patients were scheduled for different types of upper limb surgeries. All patients received infraclavicular nerve block for anaesthetic management. A double axillary vein variation was diagnosed with ultrasound during block interventions. Hydro-location technique was used in all cases and the procedures were completed uneventfully. In the current literature, there is limited number of reports concerning double axillary vein variation. Detailed knowledge of the axillary anatomy is important to avoid complications such as intravascular injection during peripheral nerve block interventions. The use of ultrasound guidance and hydro-location technique should be considered for nerve blocks, especially in the axillary area.

Anatomical traps for arteriovenous fistula creation

“…This should remind surgeons to this topography pattern when they plan to form an arteriovenous fistula in the arm with basilic vein transposition (4,12,14,15). The presented variability seems particularly interesting in the context of possible complications after the creation of MAF (7,8).…”

“…The knowledge about anatomical variabilities of upper limb venous system is intensive updating but in clinical practice still encounters some limits (5,6,12,13,14,16,17,18,19).…”

“…There are many reasons, and one of them is an intensive anatomical work that broadens knowledge about the vascular system of the upper limb (4,5,6,12,13,14,15). Classic arteriovenous fistula still seems to be a good method associated with a lower rate of complications compared to other methods (7,10).…”