Double left brachiocephalic vein with a preaortic course: a rare finding

Area of Science:

• Anatomy
• Radiology
• Vascular Surgery

Background:

• The left brachiocephalic vein (LBV) is a major venous structure formed by the confluence of the left subclavian and left internal jugular veins.
• Anatomical variations of the superior vena cava and its tributaries, including the LBV, are well-documented but typically uncommon.

Observation:

• This report details an extremely rare case of a double left brachiocephalic vein.
• A notable feature was an accessory branch with a preaortic course, with both LBV branches situated anterior to the aortic arch.

Findings:

• Computed tomography (CT) with volume-rendering (VR) imaging was utilized to visualize and characterize this rare anatomical variation.
• The detailed imaging findings confirm the presence of a duplicated LBV and its unusual anterior course relative to the aorta.

Implications:

• Recognition of such rare venous anomalies is crucial for accurate interpretation of imaging studies in cardiothoracic and vascular procedures.
• Understanding these variations aids in surgical planning and can prevent intraoperative complications during thoracic surgeries or central venous catheter placements.