Anomalies of the Brachiocephalic Vein

Anomalies of the brachiocephalic or "innominate" vein, which may be of course or number, are rare. Previously, most cases were incidentally detected during surgery or in autopsy specimens. Doppler evaluation may also demonstrate these anomalies; however, the sensitivity is poor due to suboptimal visualization of the entire course. With the advent of multidetector CT angiography, these anomalies are increasingly being detected. Although majority of cases are incidentally detected on scans performed for evaluation of congenital heart defects, these anomalies assume clinical importance when central venous cannulation or pacemaker insertion is contemplated through the anomalous side. Prior knowledge of the anomalous anatomy is also important before cardiothoracic surgeries. In this article, we present a pictorial review of the anomalies of the brachiocephalic vein using multidetector CT angiography.