S Galloway, A Bodenham  British Journal of Anaesthesia 

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Ultrasound imaging of the axillary vein'anatomical basis for central venous access  S Galloway, A Bodenham  British Journal of Anaesthesia  Volume 90, Issue 5, Pages 589-595 (May 2003) DOI: 10.1093/bja/aeg094 Copyright © 2003 British Journal of Anaesthesia Terms and Conditions

Fig 1 Simplified diagram of the anatomy of the infraclavicular region, redrawn from many sources. The pectoralis minor muscle has been reflected to facilitate the view. Note the area lateral to the rib cage, which would contain only axillary fat. Vein=axillary vein; Artery=axillary artery; PM=pectoralis minor muscle; Fat=axillary fat. British Journal of Anaesthesia 2003 90, 589-595DOI: (10.1093/bja/aeg094) Copyright © 2003 British Journal of Anaesthesia Terms and Conditions

Fig 2 A normal left axillary venogram. Contrast has been injected into a distal vein. Note the irregular outline of the vein caused by valves. Some contrast is also seen in the cephalic vein. The axillary vein is seen draining into the brachiocephalic system. Note also the incidental right-sided central venous catheter. The line a–a is the midclavicular point where the scan for Figure 3a was taken. The line b–b is 2 cm lateral to the midclavicular point and is where the scan for Figure 3b was taken. The line c–c is 4 cm lateral to the midclavicular point and is where the scan for Figure 3c was taken. British Journal of Anaesthesia 2003 90, 589-595DOI: (10.1093/bja/aeg094) Copyright © 2003 British Journal of Anaesthesia Terms and Conditions

Fig 3 Transverse ultrasound images of the axillary vessels taken with a dual-frequency 5/7.5 MHz curvilinear ultrasound probe. a is a scan from immediately below the midclavicular point (0 cm); b is a scan from 2 cm lateral; c is a scan from 4 cm further lateral. Note that from a to b to c the size of the vein decreases, the distance between the vessels increases, the arterio–venous overlap decreases and the distance between the vein and rib cage increases. Vein=axillary vein; Artery=axillary artery; RC=rib cage. British Journal of Anaesthesia 2003 90, 589-595DOI: (10.1093/bja/aeg094) Copyright © 2003 British Journal of Anaesthesia Terms and Conditions

Fig 4 Longitudinal ultrasound image of the axillary vein taken with a 7.5 MHz linear probe. Note the angle at which the vein rises up from the axilla, compared with the skin surface. British Journal of Anaesthesia 2003 90, 589-595DOI: (10.1093/bja/aeg094) Copyright © 2003 British Journal of Anaesthesia Terms and Conditions

Fig 5 Transverse ultrasound images of axillary vessels. Note the abnormal configuration of vessels. Ax=axillary vein; Art=axillary artery; Ceph=cephalic vein. British Journal of Anaesthesia 2003 90, 589-595DOI: (10.1093/bja/aeg094) Copyright © 2003 British Journal of Anaesthesia Terms and Conditions

Fig 6 Transverse ultrasound images of axillary vessels. Note the thrombus visible in the axillary vein. This thrombus was incompressible when pressure was applied with the ultrasound probe. Throm=thrombus. British Journal of Anaesthesia 2003 90, 589-595DOI: (10.1093/bja/aeg094) Copyright © 2003 British Journal of Anaesthesia Terms and Conditions