Variation in the Course and Termination of the Cephalic Vein in the Deltopectoral Triangle

Abstract

The knowledge of cephalic vein variation would aid proper identification and prevent error in surgical emergencies. The path, distribution, and termination of the cephalic vein in relation to the deltopectoral triangle were studied in twenty formalin-embalmed cadavers.Results show the bilateral presentation of the cephalic vein in all the shoulders examined. Thirtyseven (37) cases presented with a superficial and lateral course of the cephalic vein in the deltopectoral groove, while the rest three cases presented a deep course. Of these 37 cases with the superficial course, two cases ascended anteriorly and above the clavicle and drained into the external jugular vein in the neck. Another case presented a cephalic vein that ascended anteriorly and then above the clavicle and drained into an unnamed vein in the neck. In one case, the cephalic vein ascended superficially in the deltopectoral groove and laterally in the deltopectoral triangle. In one bilateral pattern, the cephalic vein in the deltopectoral triangle drained into the axillary vein. In all the three cases where the cephalic vein ascended deep within the deltopectoral groove, they terminated deep in the deltopectoral triangle. In one of these, the cephalic vein received a tributary that originated from a venous network beneath the deltoid muscle and then drained into athe xillary vein, deep in the deltopectoral triangle. In the other two cases, the cephalic vein gave a tributary to the axillary vein and continued deep and medially in the deltopectoral triangle, passed below the clavicle and drained into the subclavian vein.The knowledge of these variations of the cephalic vein is essential to clinicians and surgeons for venous access during emergencies and surgery.

Anatomical variants of upper arm veins on preoperative mapping venography for hemodialysis access in Korean adults

“…The incidence of a cephalic vein with a supraclavicular course was reported in 2% to 10% of cases in previous reports, comparable to the 3.8% of cases identified in the current study. 12,13 In the present study, venograms of arms with a previous access history were excluded to avoid confounding the original vein anatomy by previous access placements, whereas substantial proportions of patients with previous access history were included in previous reports. 4,5 In addition, previous studies either did not describe Asian patients as part of their study populations or the numbers of Asian patients included in these studies were too small; furthermore, some types of anatomical variants have not been observed in Asian groups.…”

“…The incidence of a cephalic vein with a supraclavicular course was reported in 2% to 10% of cases in previous reports, comparable to the 3.8% of cases identified in the current study. 12,13…”

A Rare Anatomical Variation of the Termination of Right and Left Cephalic Veins

“…In a previous study [ 7 ], two out of thirty-seven (5.4%) cases had cephalic vein crossed anteriorly and above the lateral third of the clavicle and terminated in the neck by draining directly into the external jugular vein. Loukas et al [ 10 ] found a collateral branch between the cephalic and the external jugular vein in 2% of 200 limbs examined.…”

“…Anastasopoulos et al [ 6 ] reported in 2% of cases the occurrence of anastomosis of cephalic vein with external juguar vein (EJV) via a communicating branch. Knowledge of these variations is essential to clinicians and surgeons for venous access during emergencies and surgery [ 7 ]. In this report, we describe a case of an anomalous cephalic vein with a bifid course of terminations on both left and right upper limbs which has not been described by the previous literature.…”