Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 25;25(1):389.
doi: 10.1186/s12893-025-03144-9.

Venous Port implantation in persistent left superior vena cava with azygos vein variation: a case report and literature review

Li Zhang  1 , Jingjin Wu  2
Affiliations

Venous Port implantation in persistent left superior vena cava with azygos vein variation: a case report and literature review

Li Zhang et al. BMC Surg. .

Abstract

Background: Persistent left superior vena cava catheterization for venous port is still sporadically reported, let alone combined with variations of the azygos.

Case presentation: During the implantation of a venous access port in a 73-year-old patient, who was planned to carry out postoperative chemotherapy, a persistent left superior vena cava was discovered. A review of the preoperative plain chest computed tomography further corroborated the existence of a double superior vena cavas. Besides, the right azygos vein was absent and a left azygos vein draining into the persistent left superior vena cava was evident. The diameter of the persistent left superior vena cava was greater than that of the right SVC. Consequently, the decision was made to insert the catheter into the persistent left superior vena cava for the subsequent implantation procedures. The surgery was successful and no complications related to the venous port occurred during the whole catheter days.

Conclusions: The rare persistent left superior vena cava with variant azygos vein should not be a contraindication for venous port implantation after a comprehensive evaluation.

Supplementary Information: The online version contains supplementary material available at 10.1186/s12893-025-03144-9.

Keywords: Azygos vein; Persistent left superior vena cava; Variation; Venous port.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: This case report’s ethical review and approval were obtained from the Ethics Committee of the Fourth Affiliated Hospital Zhejiang University School of Medicine (K2024242). Consent for publication: We obtained written informed consent from the patient for the publication of this case report and any accompanying images. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Intraoperative angiography. A The catheter is located in the left mediastinum. B Angiography confirmed the PLSVC. C Angiography confirmed the left brachiocephalic vein was absent. D Final fluoscopy
Fig. 2
Fig. 2
Review of the preoperative pulmonary CT. A Coronal plane. B Axial image
Fig. 3
Fig. 3
Ultrasound examination of SCV-AxV before removal and no venous thrombosis was found. A Visible segment of the SCV/AxV. B Color Doppler flow imaging
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Savu C, Petreanu C, Melinte A, Posea R, Balescu I, Iliescu L, Diaconu C, Galie N, Bacalbasa N. Persistent left superior Vena Cava - Accidental finding. Vivo. 2020;34(2):935–41. 10.21873/invivo.11861. - PMC - PubMed
    1. Sheikh AS, Mazhar S. Persistent left superior Vena Cava with absent right superior Vena Cava: review of the literature and clinical implications. Echocardiography. 2014;31(5):674–9. 10.1111/echo.12514. - PubMed
    1. Laurenzi L, Natoli S, Pelagalli L, Marcelli ME, Abbattista D, Carpanese L, Arcuri E. Long-term central venous catheterization via persistent left superior Vena cava: a case report. Support Care Cancer. 2003;11(3):190–2. 10.1007/s00520-002-0421-9. - PubMed
    1. Li J, Mao Q, Sun Z, Li Q. A rare variant between the left superior Vena Cava and the Azygos vein. Surg Radiol Anat. 2017;39(1):107–9. 10.1007/s00276-016-1705-y. - PubMed
    1. Kim HN, Lee Y, Hong SJ, Kang JH, Jung JH. CT findings of azygos venous system: congenital variants and acquired structural changes. J Korean Soc Radiol. 2024;85(1):95–108. 10.3348/jksr.2023.0079. - PMC - PubMed

LinkOut - more resources