Venous Port implantation in persistent left superior vena cava with azygos vein variation: a case report and literature review.

Background: Persistent left superior vena cava catheterization for venous port is still sporadically reported, let alone combined with variations of the azygos.

Case Presentation: During the implantation of a venous access port in a 73-year-old patient, who was planned to carry out postoperative chemotherapy, a persistent left superior vena cava was discovered. A review of the preoperative plain chest computed tomography further corroborated the existence of a double superior vena cavas. Besides, the right azygos vein was absent and a left azygos vein draining into the persistent left superior vena cava was evident. The diameter of the persistent left superior vena cava was greater than that of the right SVC. Consequently, the decision was made to insert the catheter into the persistent left superior vena cava for the subsequent implantation procedures. The surgery was successful and no complications related to the venous port occurred during the whole catheter days.

Conclusions: The rare persistent left superior vena cava with variant azygos vein should not be a contraindication for venous port implantation after a comprehensive evaluation.

Supplementary Information: The online version contains supplementary material available at 10.1186/s12893-025-03144-9.