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The totally implantable venous access device (TIVAD) gains access to the central venous system via the subclavian vein.
The first video clip in the following section Technique illustrates the topography of the vein, which is easily accessed percutaneously and courses superior to the first rib, posterior to the clavicle and anterior to the anterior scalene muscle.
This large caliber vein attaches to the clavipectoral fascia, and after its union with the internal jugular vein, thereby becoming the brachiocephalic vein, it courses to the right atrium of the heart.
The catheter of the TIVAD system follows this very course.