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# Axillary vein

The axillary vein runs through the armpit beside the axillary artery; it drains the arm into the [subclavian vein](https://durgical.com/en/anatomy/subclavian-veins/).

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## What it is

The large vein in the armpit beside the axillary artery.

## What it does

Drains the arm into the subclavian vein.

## Key points

- Lies medial to the axillary artery, slightly in front, along its whole course, with the [ulnar nerve](https://durgical.com/en/anatomy/ulnar-nerve/) and the medial cutaneous nerves between them
- It is the upper limit of a standard axillary lymph node dissection; injury to it is one of the operation's main risks
- Its outer segment, below the [clavicle](https://durgical.com/en/anatomy/clavicle/) and outside the [chest](https://durgical.com/en/anatomy/region/chest/), is used for ultrasound-guided pacemaker leads and central lines

## Key facts

**Drains**
Basilic and [brachial veins](https://durgical.com/en/anatomy/brachial-veins/) (+ cephalic)

**Into**
Subclavian vein at the 1st rib

## Relations

**Course**
Rises from the lower border of [teres major](https://durgical.com/en/anatomy/teres-major/) through the axilla to the outer border of the [first rib](https://durgical.com/en/anatomy/first-rib/), receiving the [cephalic vein](https://durgical.com/en/anatomy/cephalic-vein/) above [pectoralis minor](https://durgical.com/en/anatomy/pectoralis-minor-muscle/) and veins matching the branches of the [axillary artery](https://durgical.com/en/anatomy/axillary-artery/)

**In front**
[Pectoralis major](https://durgical.com/en/anatomy/pectoralis-major-muscle/), pectoralis minor and the clavipectoral fascia

**Lateral**
Axillary artery and the cords of the [brachial plexus](https://durgical.com/en/anatomy/roots-of-brachial-plexus/)

**Medial**
The arm's medial [skin](https://durgical.com/en/anatomy/skin/) nerve and the lateral group of the axillary lymph nodes

## How to find it

Not palpable. It lies medial to the axillary artery, with the arm abducted. For ultrasound-guided central access it is punctured below the clavicle, lateral to the first rib, where it appears as a compressible vein next to the pulsating artery.

## On imaging

Ultrasound shows a compressible vein medial to the pulsating artery below the clavicle; failure to compress suggests a clot. Venography or CT with the arm raised shows thrombosis or compression.

## Clinical notes

- Effort thrombosis (Paget-Schroetter) usually starts where the vein becomes the subclavian vein at the first rib
- During axillary dissection the vein is the upper landmark; the thoracodorsal bundle and the [long thoracic nerve](https://durgical.com/en/anatomy/long-thoracic-nerve/) run below and behind it and are spared
- Access through the axillary vein, outside the chest, lowers the risk of pneumothorax and catheter pinch-off compared with the subclavian route
- Penetrating wounds of the axilla often injure vein, artery and brachial plexus together

## Anatomical variants

- The level where the brachial and basilic veins unite to form it varies, as do its tributaries

## Related conditions

- [Thoracic outlet syndrome](https://durgical.com/en/conditions/thoracic-outlet-syndrome/)

## Test yourself

Think of the answer, then tap the question to see it.

## Where does the axillary vein lie relative to the axillary artery?

Medial to it, slightly in front, along its whole course, with the ulnar nerve and medial cutaneous nerves between them.

## What role does the axillary vein play in axillary lymph node dissection?

It is the upper limit of a standard dissection; injury to it is one of the main risks.

## What is the advantage of axillary vein access for leads over the subclavian route?

It is outside the chest, lowering the risk of pneumothorax and catheter pinch-off.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
vena axillaris TA2 4963

**Official Spanish (DeCS)**
Vena axilar

**English (TA2)**
Axillary vein

## Related

- [Axillary artery](https://durgical.com/en/anatomy/axillary-artery/)
- [Lateral axillary nodes](https://durgical.com/en/anatomy/lateral-axillary-nodes/)
- [Apical axillary nodes](https://durgical.com/en/anatomy/apical-axillary-nodes/)

Sources: Terminologia Anatomica (TA2); [Anatomy, Shoulder and Upper Limb, Veins](https://www.ncbi.nlm.nih.gov/books/NBK546676/).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/anatomy/axillary-vein/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/axillary-vein/