The Cephalic Vein: Anatomical Study and Evaluation of the Coracoid Process as a Topographical Bony Landmark

Purpose: Clinicians require accurate anatomical information when gaining central venous access. Despite the cephalic vein (CV) cut-down procedure being described as a superior choice to other methods (Cavallaro 2014), the CV's documented anatomical variations can make it difficult to find. The CV is commonly found in the deltopectoral groove (Loukas 2008, Yeri 2009). However, the deltopectoral groove spans the entire shoulder region, from the clavicle superiorly, to the axilla inferiorly. We asked if the coracoid process (CP) could be utilized as an accurate topographical landmark to locate the CV during ventral venous access procedures. We hypothesized that the CV would be located within 1 cm of the CP with statistical significance. Methods: We used 42 cadaver donors and conducted bilateral dissections on the shoulder region to determine the location of the CV in relation to the CP. Measurements were taken from the center of the CP, as determined by palpation through the muscle to the center of the CV. Distances were measured horizontally, vertically and directly from the CP to the CV. This method was chosen so that clinicians could use our data to locate the cephalic vein by palpating the CP on their patients. Results: The CV was found to be located less than or equal to 1 cm from the CP with a P-value of 0.000134446. Conclusions: Based on this study, we show that the CV can be located within 1 cm of the CP, making the CP an accurate topographical landmark for clinicians.