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Published on: April 18, 2013
Clinical and anatomical features of the lateral costal artery and vein
Seshiru Nakazawa1, Natsuko Kawatani1, Kai Obayashi1
1Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Japan.
Insights
Lateral costal vessels, important for thoracic surgeons, were found in 19% of patients, more often in males. Awareness of these vessels is crucial for surgical safety.
Area of Science:
- Anatomy
- Vascular Surgery
- Radiology
Background:
- Lateral costal vessels are often overlooked but clinically significant, particularly in cardiothoracic surgery.
- Understanding their prevalence and anatomical variations is essential for surgical planning and patient safety.
Purpose of the Study:
- To determine the prevalence and describe the clinical, anatomical, and radiological features of lateral costal vessels.
- To highlight the importance of recognizing these vessels in thoracic surgical procedures.
Main Methods:
- Retrospective analysis of intraoperative images from thoracic surgery patients (January 2016 - March 2020).
- Evaluation of clinical data, surgical videos, and radiological features including length, laterality, and extension beyond the 2nd intercostal space.
- Assessment of intraoperative (indocyanine green) and preoperative (3D CT) identification methods.
Main Results:
- Overall prevalence of lateral costal vessels was 19%, significantly higher in males (22%) than females (14%).
- In 74% of cases, these vessels extended beyond the 2nd intercostal space, with variations in length between sides in bilateral occurrences.
- Effective identification was achieved using indocyanine green intraoperatively and 3D CT preoperatively.
Conclusions:
- Lateral costal vessels exhibit a notable prevalence, necessitating greater physician awareness, especially among cardiothoracic surgeons.
- Preoperative and intraoperative imaging modalities can aid in the identification of these vessels, improving surgical outcomes.
- Acknowledging the anatomical characteristics of lateral costal vessels is vital for preventing complications during thoracic interventions.
Abstract:
The lateral costal artery and vein are under recognized yet potentially important vessels for physicians, especially cardiothoracic surgeons. This study sought to determine the prevalence and clinical, anatomical, and radiological features of lateral costal vessels. We retrospectively analyzed lateral costal vessels based on intraoperative images in patients who underwent thoracic surgery at our institute between January 2016 and March 2020. Clinical data and surgical videos were analyzed for patient characteristics, prevalence, length, laterality, and additional anatomical and radiological features. The overall prevalence of lateral costal vessels was 19% and was significantly higher in males than females (22% vs. 14%, p = 0.003). The lateral costal vessels extended beyond the 2nd intercostal space in 74% of the cases, with differing length between the right and left sides in bilateral cases. Lateral costal vessels could be identified intraoperatively using indocyanine green or preoperatively through three-dimensional computed tomography. The prevalence of lateral costal vessels is relatively high and should be acknowledged by physicians prior to procedures involving the vessels.
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