innominate vein

In the literature, there have been cases of injury or laceration of innominate vein, innominate artery, esophagus, trachea, brachial plexus, and even vena cava or compression on vena cava because of posterior dislocation and cases having symptoms due to compression of tumours of head of clavicle (2-9).

Cardiac CTA demonstrated an abnormal vessel traversing between the left innominate vein and the CS [Figure 1]b and [Figure 1]d; then, the blind end of the CS from the right atrium was recognized [Figure 1]c and [Figure 1]d.

LaMonte hypothesized that since the right innominate vein lies in close contact with the right apical pleura, any increase in intrathoracic pressure would increase the pressure on the IJV, making phlebectasia more common on the right side [3].

Specifically, it extended to the bifurcation of the trachea on the dorsal side of the superior vena cava, the innominate vein, the aortic arch, and the ventral side of the trachea.

Venogram showed totally occluded right subclavain vein and left innominate vein. Venoplasty was done which on followup showed a normalization of arm and resumption of dialysis through AV fistula.

Variations exist such that the innominate vein and/or right superior vena cava (SVC) may or may not be present.

Caption: Figure 1: (a) An uptake in the 18F-fluoro-D-glucose PET and (b) small depletion defect in the innominate vein growing towards the superior cava vein, and when we did the fusion with CT scan, (c) intravascular metastasis was found.

Only 3% of patients are reported to have PAPVC from the left lung to the left innominate vein [5].

Contrast enhanced computed tomography (CT) of the thorax showed chronic occlusion of the left-sided central veins with the presence of a cervical collateral venous flow from the left to the right side reaching the nonoccluded right-sided central veins, specifically the confluence to the right innominate vein (IV) and, as part of the collateral circulation, a transverse connecting, in parts quite tortuous, and u-shape midline jugular vein measuring about 3 mm in diameter (Figure 1).

But in those cases in which right pulmonary veins were draining into SVC, SVC was cannulated at the junction of SVC and innominate vein. In all cases, SVC was cannulated with right angled metal tip venous cannula.