Related Experiment Video

Updated: Apr 19, 2026

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion
03:22

Local Anesthetic Thoracoscopy for Undiagnosed Pleural Effusion

Published on: November 10, 2023

2.1K

Looking a bit superficial to the pleura

Pablo Blanco1, Giovanni Volpicelli2

  • 1Intensive Care Unit, Hospital Dr. Emilio Ferreyra, 4801, 59 St, Necochea 7630, Argentina.

Critical Ultrasound Journal
|December 10, 2014
PubMed

Insights

Ultrasonography easily identifies internal thoracic vessels (ITA and ITV) along the parasternal line. This technique aids in preventing injury during pericardiocentesis and assessing coronary artery bypass graft patency.

Area of Science:

  • Anatomy
  • Medical Imaging
  • Vascular Surgery

Background:

  • The internal thoracic artery (ITA) originates from the subclavian artery, running bilaterally near the sternum with accompanying internal thoracic veins (ITV).
  • Accurate identification of ITA and ITV is crucial for preventing iatrogenic injury during parasternal pericardiocentesis.
  • Recognizing these vessels is also vital for evaluating the patency of ITA grafts in patients with coronary artery disease experiencing chest pain.

Purpose of the Study:

  • To present a straightforward ultrasonographic method for identifying the internal thoracic artery and vein.
  • To emphasize the clinical significance of recognizing these vessels in specific patient scenarios.

Main Methods:

  • Utilized a linear probe along the parasternal line for grayscale imaging.
  • Employed Color Doppler to differentiate pulsatile flow (ITA) from non-pulsatile flow (ITV).
  • Applied Spectral Doppler to analyze flow velocity profiles, distinguishing between native and grafted arteries.

Main Results:

  • Internal thoracic vessels appear as anechoic tubular structures anterior to the pleural line on grayscale ultrasound.
  • Color Doppler clearly distinguishes the pulsatile arterial flow from the non-pulsatile venous flow.
  • Spectral Doppler reveals characteristic high-resistance flow in native ITAs and biphasic low-resistance flow in patent ITA grafts.

Conclusions:

  • The internal thoracic artery (non-grafted) and vein are routinely identifiable using parasternal ultrasonography.
  • Sonographic identification is essential for guiding safe pericardiocentesis and assessing ITA graft permeability in relevant clinical contexts.
Abstract

Keywords:
CABGInternal thoracic vesselsPericardiocentesisUltrasonography

More Related Videos

Point-of-Care Lung Ultrasound in Adults: Image Acquisition09:17

Point-of-Care Lung Ultrasound in Adults: Image Acquisition

Published on: March 3, 2023

8.3K
Thoracoscopic Extended Right Middle Plus Lower Sleeve Lobectomy for Non-Small-Cell Lung Cancer11:17

Thoracoscopic Extended Right Middle Plus Lower Sleeve Lobectomy for Non-Small-Cell Lung Cancer

Published on: February 27, 2026

572

Related Concept Videos

Pleura of the Lungs01:13

Pleura of the Lungs

The lungs are nestled in a cavity, shielded by the pleura. The pleura, a form of serous membrane, wraps around each lung. This membrane arrangement consists of two layers: the visceral and parietal pleurae. The visceral pleura lines the surface of the lungIn contrast, the parietal pleura is the outer layer and contacts to the thoracic wall, the mediastinum, and the diaphragm. The hilum is the point of connection between the visceral and parietal layers. The space between the parietal and...
11.3K
Pleural Disorders: Types and Brief Description01:30

Pleural Disorders: Types and Brief Description

The pleura is a vital part of the respiratory system. It's a double-layered membrane surrounding the lungs and lining the chest cavity. The two layers of the pleura are:
1.0K
Pleural Effusion I: Introduction01:25

Pleural Effusion I: Introduction

Pleural effusion is an abnormal fluid accumulation in the pleural cavity, a narrow space between the lungs and the chest wall. It is not a disease per se but rather a symptom or indication of an underlying disease. In normal circumstances, this space contains a small amount of fluid (5 to 15 mL), a lubricant facilitating the non-frictional movement of the pleural surfaces.
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's...
6.0K
Layers of Connective Tissue Proper01:21

Layers of Connective Tissue Proper

Fascia, a thin layer of fibrous connective tissue, is distributed throughout the body. It demarcates and forms a supportive covering over skeletal muscles, bones, blood vessels, and organs. There are three main types of facia— superficial fascia, deep fascia, and subserous fascia. These are all present at different depths in the body. Fascia reduces the friction and permits muscles, joints, and organs to easily slide against each other, facilitating movement of the body and preventing...
8.5K
Peritoneum01:21

Peritoneum

The peritoneum is a vital membrane that lines the abdominal cavity and covers most of the organs within it. It plays a crucial role in protecting the organs, providing a smooth surface for their movement, and facilitating various physiological processes. Understanding the anatomy and function of the peritoneum is essential for comprehending the complexities of the abdominal region.
Anatomy of the Peritoneum
The peritoneum is divided into two layers: the parietal peritoneum and the visceral...
13.4K
Pleural Effusion II: Symptoms and Management01:28

Pleural Effusion II: Symptoms and Management

Pleural Effusion Overview
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
1.3K