Basilic Vein

vena basilica

The basilic vein originates from the medial dorsal venous arch of the hand, ascends along the ulnar forearm, crosses the antecubital fossa medially, and runs along the medial bicipital groove. At the mid-upper arm it pierces the deep fascia and joins the brachial veins to form the axillary vein. The medial cutaneous nerve of the forearm parallels its course.

Region: Upper Arm

Clinical Relevance

Clinical Notes

The basilic vein is larger and deeper than the cephalic vein and is the preferred conduit for basilic vein transposition arteriovenous fistulas for haemodialysis access. PICC lines are most commonly inserted through the basilic vein at the antecubital fossa under ultrasound guidance. The medial antebrachial cutaneous nerve runs adjacent and must be avoided during basilic vein harvesting for fistula creation. Basilic vein is also harvested for coronary artery bypass when the saphenous vein is unavailable.

Pathology

Common Injuries & Conditions

Medial Antebrachial Cutaneous Nerve Injury

Inadvertent injury during basilic vein harvesting or PICC insertion produces medial forearm numbness or dysaesthesia, a recognised complication that can be avoided with careful dissection and knowledge of the nerve's relationship to the vein.

Basilic Vein Thrombosis

Medial forearm superficial thrombophlebitis from PICC catheters or repeated venepuncture produces tenderness along the medial forearm; complications include propagation to the axillary vein and risk of septic thrombophlebitis from infected PICC lines.