(c) Superior vena cava (black arrow) and left brachiocephalic
vein (white arrow).
Furthermore, the right brachiocephalic trunk being larger than the left brachiocephalic
trunk was also in support of the conclusion that the flamingo is a unicarotid species with a permanent right carotid artery.
However, we were unable to advance the lead through the junction of the left brachiocephalic
vein and superior vena cava (SVC) due to an acute angle.
After a discussion with the surgeon, it was decided that we should explore the left brachiocephalic
In case of persistent left IVC, possible routes for the return of blood to the right atrium are via the azygos vein to the SVC, via the hemiazygos vein to persistent left SVC or via the left brachiocephalic
vein to right SVC (4).
The compressive symptoms, however, worsened over the first 4 days following treatment start, requiring, initially, stent insertion in the SVC and, subsequently, the left brachiocephalic
It then continues up under the left brachiocephalic
vein, feeding into the venous circulation at or near the junction of the internal jugular and left subclavian veins at the base of the neck (4).
A portion of the left subclavian vein and probably the left brachiocephalic
vein are also thrombosed.
Aside from the jugulosubclavian junction, the thoracic duct can also terminate in the internal jugular vein, the subclavian vein, and the left brachiocephalic
(innominate) vein, and each duct can have multiple termination points into each of these veins.
Normal structures in the prevascular compartment include the thymus, fat, lymph nodes and the left brachiocephalic
This metastasis was invading the proximal region of the left brachiocephalic
vein with a progressive intravascular growing that filled and expanded the superior vena cava (SVC).
In our case, the right subclavian catheter tip, lead in a straight route through the right brachiocephalic vein, could be in contact and cause injury to the left brachiocephalic
vein endothelium at the point near to its junction to the superior vena cava.