Variations of the cephalic vein anterior to the clavicle in humans
Abstract
Background: Clinicians should understand that jugulocephalic vein (JCV) variants may be occasionally found. This study aims to classify JCV variants and obtain their frequency.
Materials and methods: We investigated anatomical variants of the cephalic vein in 55 human cadavers during a gross anatomy course at our medical school.
Results: The percentage of JCVs that pass through the anterior part of the clavicle and anastomose to the jugular vein as per previous studies and our study was 2–5%. Five cases with anastomosis between the cephalic and external jugular veins that pass through the anterior part of the clavicle were found. The courses were classified into 1A, 1B, 2A, and 2B. Type 1 extends beyond the clavicle and anastomoses with the external jugular vein. Type 2 follows the same course as type 1, but anastomoses with the subclavian vein. Subtype A does not have a branch that anastomoses with the axillary vein, whereas subtype B does. We encountered two cases of type 1A and three of type 1B.
Conclusions: 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.
Keywords: cadaversclaviclejugulocephalic veinanatomical variants
References
- Anastasopoulos N, Paraskevas G, Apostolidis S, et al. Three superficial veins coursing over the clavicles: a case report. Surg Radiol Anat. 2015; 37(9): 1129–1131.
- De Maria E, Cappelli S. Cephalic vein with a supraclavicular course: rare, but do not forget it exists! J Cardiovasc Med (Hagerstown). 2017; 18(9): 727–728.
- Deslaugiers B, Vaysse P, Combes JM, et al. Contribution to the study of the tributaries and the termination of the external jugular vein. Surg Radiol Anat. 1994; 16(2): 173–177.
- Hieda G. About japanese subcutaneous veins in upper limb. Acta Medica. 1927; 1: 54–59.
- Kim DI, Han SH. Venous variations in neck region: cephalic vein. Int J Anat Var. 2010; 3: 208–210.
- Lau EW, Liew R, Harris S. An unusual case of the cephalic vein with a supraclavicular course. Pacing Clin Electrophysiol. 2007; 30(5): 719–720.
- Le Saout J, Vallee B, Person H, et al. [Anatomical basis for the surgical use of the cephalic vein (V. Cephalica). 74 anatomical dissections. 189 surgical dissections]. J Chir (Paris). 1983; 120(2): 131–134.
- Loukas M, Myers CS, Wartmann ChT, et al. The clinical anatomy of the cephalic vein in the deltopectoral triangle. Folia Morphol. 2008; 67(1): 72–77.
- Mochizuki S. Japanese cervical veins. Keio J Med. 1925; 5: 245–314.
- Nayak BS, Soumya KV. Abnormal Formation and Communication of External Jugular Vein. Int J Anat Var. 2008; 1: 15–16.
- Padget DH. The cranial venous system in man in reference to development, adult configuration, and relation to the arteries. Am J Anat. 1956; 98(3): 307–355.
- Parsonnet V, Roelke M. The cephalic vein cutdown versus subclavian puncture for pacemaker/ICD lead implantation. Pacing Clin Electrophysiol. 1999; 22(5): 695–697.
- Patil RA, Rajgopal L, Iyer P. Absent external jugular vein – ontogeny and clinical implications. Int J Anat Var. 2013; 6: 103–105.
- Plakornkul V, Manoonpol C. The patterns of the cephalic veins termination. Siriraj Med J. 2006; 58: 1204–1207.
- Seldinger SI. Catheter replacement of the needle in percutaneous arteriography; a new technique. Acta Radiol. 1953; 39(5): 368–376.
- Shimada H, Hoshino K, Yuki M, et al. Percutaneous cephalic vein approach for permanent pacemaker implantation. Pacing Clin Electrophysiol. 1999; 22(10): 1499–1501.
- Świętoń EB, Steckiewicz R, Grabowski M, et al. Selected clinical challenges of a supraclavicular cephalic vein in cardiac implantable electronic device implantation. Folia Morphol. 2016; 75(3): 376–381.
- Świętoń E, Steckiewicz R, Stolarz P, et al. Supraclavicular course of the cephalic vein — implications for cardiac electronic device implantation. Folia Cardiol. 2015; 10(5): 200–203.
- Tokano T, Nakazato Y, Shiozawa T, et al. Variations in cephalic vein venography for device implantation–Relationship to success rate of lead implantation. J Arrhythm. 2013; 29(1): 9–12.
- Trigano A, D'Ivernois C, Levy S, et al. Preclavicular route following cephalic venous cutdown for pacemaker or defibrillator lead implantation. Pacing Clin Electrophysiol. 2007; 30(1): 147–149.
- Tse HF, Lau CP, Leung SK. A cephalic vein cutdown and venography technique to facilitate pacemaker and defibrillator lead implantation. Pacing Clin Electrophysiol. 2001; 24(4 Pt 1): 469–473.
- Villegas F, Restrepo A, Rodríguez D, et al. Supraclavicular course of the cephalic vein. Int J Case Rep Imag. 2014; 5(4): 281.
- Webre DR, Arens JF. Use of cephalic and basilic veins for introduction of central venous catheters. Anesthesiology. 1973; 38(4): 389–392.
- Wendth AJ. Peripheral arteriography an overview of its origins and present status. CRC Crit Rev Clin Radiol Nucl Med. 1975; 6(3): 369–401.
- Wysiadecki G, Polguj M, Topol M. Persistent jugulocephalic vein: case report including commentaries on distribution of valves, blood flow direction and embryology. Folia Morphol. 2016; 75(2): 271–274.
