AXILLARY VEIN

The axillary vein is a continuation of the brachial and basilic veins and continues to become the subclavian vein at the lateral border of the first rib.

The infraclavicular axillary vein is located in the delto-pectoral groove, deep to the pectoralis minor muscle. As the vein traverses lateral to the second rib, it begins to separate from the chest wall and the underlying pleural cavity. The axillary vein is situated inferior to the axillary artery. The separation between the artery and vein is variable. Sometimes there is no space between the artery and vein, and other times there is 1-3 cm of space.

The delto-pectoral groove also serves as a major landmark for the axillary vein. In the middle section of the groove, there is a relatively large gap formed between the vein and the rib cage providing some advantage to using the axillary vein for CVC insertion. Even further laterally, the vein is relatively free of vulnerable structures including the axillary artery. However, close to the site of CVC placement, the vein does come into close proximity to the brachial plexus; the vein, artery and brachial plexus travel in a neurovascular bundle (19).

Landmarks include:
 · Delto-pectoral groove

Adjacent anatomy includes:
 · Cephalic vein
 · Subclavian vein
 · First rib
 · Clavicle