Implantation of a Totally Implantable Venous Access Device in a Patient with Bilateral Superior Vena Cava: A Case Report
DOI:
https://doi.org/10.3941/jrcr.6130Abstract
Bilateral superior vena cava (BSVC) is a rare congenital venous anomaly, often asymptomatic and discovered incidentally during invasive procedures. We present a 43-year-old woman with right breast cancer (BI-RADS 5) who underwent implantation of a totally implantable venous access device (TIVAD) via the left internal jugular vein approach under digital subtraction angiography (DSA) guidance. Intraoperatively, a persistent left superior vena cava (PLSVC) forming a BSVC was identified. Catheter placement was successfully completed with the tip positioned at the level of the 7th posterior rib, confirmed by DSA and post-procedural CT. This case highlights that a left-sided approach in breast cancer patients may unveil an occult BSVC. DSA-guided bilateral venography and precise catheter tip positioning are crucial for safe TIVAD implantation in patients with this anatomical variation. Our report provides a practical reference for managing similar cases.
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