Right Brachiocephalic Vein in Pediatrics

The right brachiocephalic vein (RBCV) is a prominent vein located in a retroclavicular/sternal position, oriented vertically toward the superior vena cava. Puncture is performed using a long-axis (LAX) view of the supraclavicular fossae, to apply the dynamic needle tracking (DNT) technique. Cannulation of the RBCV is technically more demanding compared to the left, as the trajectory of the introducer needle is almost parallel to the insonation area of the transducer. The pleura is adjacent to the posterior and lateral sides of the right BCV. Due to its deep location, the RBCV is not amenable to direct compression techniques in the event of hemorrhage secondary to coagulation disorders, thus constituting a contraindication for its puncture.