Persistent Left Superior Vena Cava: Clinical and Procedural Challenges.

Persistent left superior vena cava (PLSVC) is an under-recognized thoracic venous anomaly. It typically drains venous blood from the left arm and neck, and often terminates in the coronary sinus on the right side of the heart. Although often asymptomatic, PLSVC is frequently discovered incidentally during imaging or interventional procedures. This anatomical variation can pose challenges during procedures such as venous catheterization and pacemaker placement, due to its atypical drainage route. This report presents a case of PLSVC in a patient who underwent placement of a peripherally inserted central venous catheter through the left arm, aiming to raise awareness of this anatomical variation among healthcare professionals. It includes a brief review of the embryology and anatomy of PLSVC, emphasizing that improved recognition and understanding of this venous anomaly can enhance diagnostic accuracy and procedural safety.