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Internal thoracic artery

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Title: Internal thoracic artery  
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Subject: Superior epigastric artery, Intercostal arteries, Pericardiacophrenic artery, Coronary artery bypass surgery, Superior thoracic artery
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Internal thoracic artery

Internal thoracic artery
Right internal thoracic artery and its branches (labeled under its old name the Internal mammary artery, at upper right.)
Details
Latin Arteria thoracica interna, arteria mammaria interna
Source Subclavian artery
Branches Pericardiophrenic
Anterior intercostal branches
Musculophrenic
Superior epigastric
Perforating branches
Internal thoracic vein
Identifiers
MeSH A07.231.114.891.525
Dorlands
/Elsevier
a_61/12156309
Anatomical terminology

In human anatomy, the internal thoracic artery (ITA), previously known as the internal mammary artery (a name still common among surgeons), is an artery that supplies the anterior chest wall and the breasts. It is a paired artery, with one running along each side of the sternum, to continue after its bifurcation as the superior epigastric and musculophrenic arteries.

Contents

  • Structure 1
    • Branches 1.1
  • Clinical significance 2
    • Use in bypass grafts 2.1
  • Additional images 3
  • References 4
  • External links 5
    • Figures of ITA grafts 5.1

Structure

The internal thoracic artery arises from the subclavian artery near its origin.

It travels downward on the inside of the ribcage, approximately a centimeter from the sides of the sternum, and thus medial to the nipple. It is accompanied by the internal thoracic vein.

It runs deep to the internal intercostal muscles, but superficial to the transverse thoracic muscles.

It continues downward until it divides into the musculophrenic artery and the superior epigastric artery around the sixth intercostal space.

Branches

After passing the sixth intercostal space, the internal thoracic artery splits into the following two terminal branches:

Clinical significance

Use in bypass grafts

The internal thoracic artery is the cardiac surgeon's blood vessel of choice for coronary artery bypass grafting. The left ITA has a superior long-term patency to saphenous vein grafts[1][2] and other arterial grafts[3] (e.g. radial artery, gastroepiploic artery) when grafted to the left anterior descending coronary artery, generally the most important vessel, clinically, to revascularize.

Plastic surgeons may use either the left or right internal thoracic arteries for autologous free flap reconstruction of the breast after mastectomy. Usually a micro-vascular anastomosis is performed at the second intercostal space to the artery on which the free flap is based.

Additional images

References

  1. ^ Kitamura, S; Kawachi, K; Kawata, T; Kobayashi, S; Mizuguchi, K; Kameda, Y; Nishioka, H; Hamada, Y; Yoshida, Y (1996). "Ten-year survival and cardiac event-free rates in Japanese patients with the left anterior descending artery revascularized with internal thoracic artery or saphenous vein graft: a comparative study". Nippon Geka Gakkai zasshi 97 (3): 202–9.  
  2. ^ Arima, M; Kanoh, T; Suzuki, T; Kuremoto, K; Tanimoto, K; Oigawa, T; Matsuda, S (2005). "Serial angiographic follow-up beyond 10 years after coronary artery bypass grafting". Circulation journal : official journal of the Japanese Circulation Society 69 (8): 896–902.  
  3. ^ Cohen, G; Tamariz, MG; Sever, JY; Liaghati, N; Guru, V; Christakis, GT; Bhatnagar, G; Cutrara, C; et al. (2001). "The radial artery versus the saphenous vein graft in contemporary CABG: a case-matched study". The Annals of thoracic surgery 71 (1): 180–5; discussion 185–6.  

External links

  • -502923206 at GPnotebook - Internal thoracic artery

Figures of ITA grafts

  • Figure of heart with two saphenous vein grafts (SVGs) and a LITA graft - texheartsurgeons.com
  • Drawing of the heart with a SVG to the right coronary artery (RCA) and a LITA graft to the LAD - darcystudios.com
  • Drawing of the heart with a SVG to the RCA and a LITA graft to the LAD - mayoclinic.org
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