Subclavian Vein

vena subclavia

The subclavian vein is the main venous return from the upper limb, joining the internal jugular vein to form the brachiocephalic vein at the venous angle. Its position anterior to the anterior scalene muscle distinguishes it from the subclavian artery which lies posterior. The thoracic duct drains into the left subclavian vein at the venous angle — making left-sided neck dissection at risk for thoracic duct injury and chyle leak.

Region: Chest

Anatomical Data

Origin, Insertion & Supply

Origin	Continuation of the axillary vein at the lateral border of the first rib

Clinical Relevance

Clinical Notes

The subclavian approach for central venous catheterisation has a higher pneumothorax risk than the IJV approach because the pleura lies close behind the subclavian vein. Pinch-off syndrome occurs when a subclavian vein catheter placed too medially is compressed between the clavicle and first rib, producing catheter fracture and catheter embolism. Paget-Schroetter syndrome (effort thrombosis) is subclavian vein thrombosis from thoracic outlet compression during overhead arm activities in athletes.

Pathology

Common Injuries & Conditions

Paget-Schroetter Syndrome

Subclavian vein effort thrombosis from thoracic outlet compression during overhead arm activities in athletes, producing arm swelling and cyanosis managed with thrombolysis and first rib resection.