Thoracodorsal Vein

vena thoracodorsalis

The thoracodorsal vein accompanies the thoracodorsal artery along the posterior axillary wall, draining the latissimus dorsi and the serratus anterior, and joining the subscapular vein to reach the axillary vein. It is the venous drainage of the latissimus dorsi flap and must be included in the free flap pedicle during microsurgical breast reconstruction.

Region: Chest

Clinical Relevance

Clinical Notes

The thoracodorsal vein is the principal venous pedicle for the latissimus dorsi free flap in microsurgical reconstruction. Its calibre (typically 2-3 mm) and length determine the ease of microsurgical anastomosis. Prior axillary dissection may have injured or thrombosed the thoracodorsal vein, making preoperative assessment essential. In sentinel lymph node biopsy, the blue dye injection sometimes stains the thoracodorsal vein, mistaking it for a lymphatic channel at the operative site.

Pathology

Common Injuries & Conditions

Thoracodorsal Vein Assessment Before Latissimus Flap

Previous axillary clearance for breast cancer may have ligated or damaged the thoracodorsal vein, rendering the latissimus dorsi free flap unreliable as the venous pedicle is absent; preoperative duplex imaging or angiography confirms patency before committing to a latissimus flap for breast reconstruction.