Left Brachiocephalic Vein in Pediatrics

The left brachiocephalic vein (LBCV) is a substantial retroclavicular vein that extends transversally from left to right, originating from the confluence of the left internal jugular vein and the left subclavian vein. Its puncture is performed using a long-axis (LAX) view from the supraclavicular fossae, employing the dynamic needle tracking (DNT) technique. In contrast to the puncture of the right brachiocephalic vein, the introducer needle for accessing the LBCV is fully visualized in-plane, facilitating cannulation while avoiding penetration of the posterior wall and the underlying pleura. Although the vein is superficial, its retroclavicular location precludes the possibility of compression in the event of bleeding due to coagulation disorders. Therefore, attempting this access in patients with such conditions is contraindicated.