CTICasesAccessory Left Brachiocephalic Vein
Imaging findings
Contrast-enhanced CT demonstrates a small left brachiocephalic vein that is compressed anteriorly between the sternum and the ascending aorta. A second, small, arcing accessory brachiocephalic vein courses anterior to the aorta, communicating with the main brachiocephalic vein and serving as an alternative collateral pathway. A tiny remnant of a thymic vein is also visualized draining into this accessory vessel.
Key takeaways
An accessory left brachiocephalic vein is a rare congenital venous anomaly that typically courses anterior to the ascending aorta and can receive drainage from thymic veins. This channel may become more prominent or open up as a collateral pathway in the setting of main brachiocephalic vein compression between the sternum and the aorta.
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