永存左上腔静脉(persistent left superior vena cava，PLSVC)是最常见的胸腔静脉解剖异常之一，给中心静脉通路的建立带来一定挑战。本文报道1例晚期乳腺癌患者合并Ⅰ型PLSVC，在数字减影血管造影（digital subtraction angiography，DSA）引导下经左锁骨下静脉成功植入静脉输液港的临床过程。术中DSA清晰显示异常静脉走行，并结合心电监护准确定位导管尖端于左上腔静脉中下1/3处，顺利完成输液港植入。术后随访104 d，输液港使用良好，未见导管相关并发症。结果表明，DSA引导能够实时识别静脉解剖变异、准确评估导管位置，提高PLSVC患者静脉输液港植入的安全性与成功率，为此类患者建立长期静脉通路提供了可靠方法。

Persistent left superior vena cava (PLSVC) is one of the most common thoracic venous anatomical anomalies and poses challenges in establishing central venous access. This report describes a patient with advanced breast cancer complicated by type I PLSVC who successfully underwent venous access port implantation via the left subclavian vein under digital subtraction angiography (DSA) guidance. Intraoperative DSA clearly demonstrated the abnormal venous pathway, and electrocardiographic monitoring was combined to accurately position the catheter tip at the middle-to-lower third of the left superior vena cava, resulting in successful port implantation. After a 104-day follow-up period, the venous access port functioned well, and no catheter-related complications were observed. These findings indicate that DSA guidance allows real-time identification of venous anatomical variations and precise evaluation of catheter position, thereby improving the safety and success rate of venous access port implantation in patients with PLSVC and providing a reliable method for establishing long-term venous access in such patients.