Retro-aortic left brachiocephalic vein
CTA neck for possible dissection.
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The left brachiocephalic vein courses inferiorly through the superior mediastinum, passing posterior to the ascending aorta and inferior to the aortic arch. It joins the right brachiocephalic vein to form the SVC. There is also a bovine aortic arch variant.
The retro-aortic left brachiocephalic vein is a rare vascular anatomic variant that may be associated with cardiac malformations.
The patient did not have evidence of arterial dissection.