Rare variations of cephalic vein drainage: two case reports

Throughout the years, anatomic studies have demonstrated numerous variations in the course of the cephalic vein (CV). There are, however, very rare cases of uncommon formation, course, or termination of the vein to which our attention should be drawn. During routine dissections conducted in the Department of Anatomy and Neurobiology, in 2 formalin-fixed cadavers, very rare anatomical variants were found. In an 80-year-old Caucasian female the right cephalic vein, after crossing the clavipectoral triangle, ascended anterior and superior to the clavicle and drained into the lateral branch of the right external jugular vein, which in turn opened to the right subclavian vein. In the second case, the dissection of an 83-year-old Caucasian male cadaver revealed that, after passing through the deltopectoral groove, the left cephalic vein ran between clavicle and subclavius muscle to terminate in the left subclavian vein. Understanding of the topography, morphology, and anatomical variations of the cephalic vein is important not only for anatomists but for clinicians and nurses. Such knowledge can prevent multiple complications during many invasive procedures including implantation of cardiac implantable electronic devices, central venous access, arteriovenous fistula creation, or iatrogenic injuries during clavicle or glenohumeral joint surgery.