Brachial vein

The femoral vein is cannulated for taking blood samples. Intravenous lines are established in the brachial vein of the right foreleg. 

Hingorani A, Ascher E, Marks N, et al. Morbidity and mortality associated with brachial vein thrombosis. Ann Vase Surg 2006 28 245—247. 

Central PN refers to the administration of PN via a large central vein, and the catheter tip must be positioned in the vena cava. Central PN allows the infusion of a highly concentrated, hypertonic nutrient admixture. The typical osmolarity of a central PN admixture is about 1500 to 2000 mOsm/L. Central veins have much higher blood flow, and the PN admixture is diluted rapidly on infusion, so phlebitis is usually not a concern. Patients who require PN administration for longer periods of time (greater than 7 days) should receive central PN. One limitation of central PN is the need for placement of a central venous catheter and an x-ray to confirm placement of the catheter tip. Central venous catheter placement may be associated with complications, including pneumothorax, arterial injury, air embolus, venous thrombosis, infection, chylothorax, and brachial plexus injury.1,20... 

Blood and Urine Collection. As mentioned previously, serial blood samples can be fairly easily collected from the dog. The jugular vein is probably the most commonly used vein because of its size and accessibility. Other veins used less frequently are the cephalic, femoral, brachial, and saphenous. 

AV differences have beeii measured for a variety of organs (e,g brain, forearm, leg, and liver). To assess brain metabolism, it is customary to take blixid. samples from the carotid artery and the hepatic vein. Forearm metabolism can be examined using blood samples from the brachial artery and a deep vein. Leg metabolism can... 

The cardiac catheterization procednre reqnires vascnlar access, nsually obtained percutaneonsly at brachial or femoral arteries or veins. Left-sided catheterization provides access to the aorta, left ventricle, and left atrinm. Right-sided catheterization enables the right side of the heart, coronary sinus, pulmonary arteries, and pulmonary wedge position to be reached. Left-sided catheterization is used for coronary angiography and ventriculography, whereas rightsided catheterization is nsed for determination of cardiac performance parameters. 

FIGURE 45-1. The predominant types of vascular access for chronic dialysis patients are (A) the arteriovenous fistula and (B) the synthetic arteriovenous forearm graft. The first primary arteriovenous fistula is usually created by the surgical anastomosis of the cephalic vein with the radial artery. The flow of blood from the higher-pressure arterial system results in hypertrophy of the vein. The most common AV graft is between the brachial artery and the basilic or... 

The needle is inserted at an angle of 45 degrees parallel to the deltopectoral groove, l-2cm medial (Figs. 4.21 and 4.22).If the vein is not entered, fluoroscopy is then used to define the first rib. The needle is advanced and touches the first rib. Sequential needle punctures are walked laterally and posteriorly until the vein is entered. It should be noted that one cannot palpate the axillary artery pulse and, thus, it is not a reliable landmark. The axillary artery and brachial plexus are usually much deeper and more posterior structures. This simple technique using basic anatomic landmarks of the... 

Using a rather unconventional puncture site for catheterization of the axillary vein, at the junction between the axillary and subclavian vein, trauma to the brachial nervous plexus is avoided, particularly when large-diameter catheters, serving for Gianturco stents for instance, are introduced (Dondelinger et al. 1991). As a general rule, venous stents should be placed sequentially, first in a distal position, then more proximally, in relation to the puncture site. When the confluence of the innominate veins is treated, the technique used depends on the anatomy and the type of stents required. Usually, the develop-... 

Local anesthesia and regional blocks, commonly used in vascular access surgery, may affect vein diameter and fistula blood flow rates, which are important predictors of fistula failure. Regional block anesthesia (brachial plexus block) is associated with vasodilation in both the cephalic and basilic veins and with increased fistula blood flow. 

This procedure involves ligation of the fistula at its origin followed by reestablishment of the fistula via a saphenous vein bypass from a more distal arterial source to the fistula (fig. 2). By using a smaller distal artery as inflow, RUDI lengthens the fistula, decreases the diameter, and preserves antegrade flow in the brachial artery. In contrast to DRIL, it is the fistula, not the native arterial supply that is placed at risk by ligation and revascularization. However, the overall success rate for radial artery-based access procedures is fairly poor in the elderly and diabetics. 

The thoracic outlet region includes the brachial plexus nerves and the subclavian artery and vein. These neurovascular structures traverse restricted spaces in which they can be compressed, the most important of which are the interscalene triangle, the costoclavicular space and the retropectoralis minor space (Fig. 6.16a) (Demondion et al. 2000). Both subclavian artery and brachial plexus nerves pass through the interscalene triangle, a space bordered by the anterior scalene musde anteriorly, the middle scalene muscle posteriorly and the first rib inferiorly. 

Fig. 6.56. Normal brachial plexus paravertebral area. Transverse 12-5 MHz US image over the left anterolateral neck demonstrates the main landmarks for identification of the nerve roots. Note the position of the left lobe of the thyroid Thy), the esophagus (Esoph), the common carotid artery (CA), the internal jugular vein (IJV) lying between the superficial sternoclei-domastoideus (SternoCt) and the deep longus colli (LC) muscles. Deep to these structures, the lateral aspect of the C6 vertebra shows a wavy hyperechoic contour, which delineates the vertebral body (1), the pedicle (2) and the transverse process (3), which exhibits in turn two prominent anterior (asterisk) and posterior (star) tubercles. The C6 root (arrow) appears as a hypoechoic image contained between these tubercles. The insert at the upper left side of the figure indicates transducer positioning...

Generally speaking, the clinically relevant structures of the thoracic outlet region are the brachial plexus nerves, the subclavian artery and the subclavian vein. The causes of brachial plexopathy include trauma, intrinsic and extrinsic tumors, radiation plexopathy and Parsonage-Turner syndrome. The neurovascular structures of the thoracic outlet... 

On the medial aspect of the arm, the brachial (humeral) artery and satellite veins (including... 

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