Incidentally Found Absence of the Left Brachiocephalic Vein with Venous Return Through the Left Superior Intercostal Vein in an Adult Patient: Venography and CT Findings

ABSTRACT

A 63-year-old male patient was referred for venography of the thoracic venous system and multidetector computed tomography (CT) due to the unusual location of the left subclavian catheter tip. His venogram and CT images showed an absence of the left brachiocephalic vein (LBCV). Instead of through the LBCV, the usual venous circulation of neck and left upper limb was carried out by the engorged left superior intercostal vein (LSIV); this subsequently drained into the accessory hemiazygos vein and then the azygos vein that drains into the superior vena cava. Here, we report a rare case of an incidentally found absence of the LBCV with venous return through the LSIV in an adult patient, and we present a brief review of the relevant literature.