Double axillary vein variation diagnosed with ultrasound guidance during infraclavicular nerve block intervention

The use of ultrasound guidance increases the safety of peripheral block interventions by allowing anaesthesiologists to simultaneously see the position of block needle, the targeted nerves and surrounding vessels. In this report, we represented three patients diagnosed with double axillary vein variation with ultrasound guidance during infraclavicular nerve block intervention. The patients were scheduled for different types of upper limb surgeries. All patients received infraclavicular nerve block for anaesthetic management. A double axillary vein variation was diagnosed with ultrasound during block interventions. Hydro-location technique was used in all cases and the procedures were completed uneventfully. In the current literature, there is limited number of reports concerning double axillary vein variation. Detailed knowledge of the axillary anatomy is important to avoid complications such as intravascular injection during peripheral nerve block interventions. The use of ultrasound guidance and hydro-location technique should be considered for nerve blocks, especially in the axillary area.

MR and CT anatomy of the axilla

Purpose: to depict the complex anatomy of the axilla with CT and MR imaging. Material and Methods: the axillary regions of 2 cadavers (with arms hyperabduct-ed) were examined by means of CT and MR. in this position the cadavers were frozen and cryosectioned. the anatomical sections documented by the MR and CT images were compared and anatomical structures were designated. to show the reproducibility of the anatomical structures and to find variations, 20 volunteers were also examined by MR, and 20 consecutive patients without axillary symptoms were examined by CT. Results: the complexity of the axilla was excellently shown by both CT and MR, but MR was able to demonstrate more detail in the small vessels and in the brachial plexus. the comparability of the examinations of the different individuals was best in the axial plane. Some differences appeared in the coronal and sagittal planes caused by different positions of the arm. Conclusion: Axillary anatomy was demonstrated in detail and was reproducible with CT and MR imaging.