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Published on: March 27, 2018
A study on origin, termination, and course characteristics of internal thoracic artery relevant to coronary surgeries
Gaurav Agnihotri1, Anureet Mitra1
1Department of Anatomy, Government Medical College, Amritsar, Punjab, India.
Insights
The internal thoracic artery typically originates from the subclavian artery and most commonly terminates in the sixth intercostal space. Understanding these anatomical variations is crucial for surgical success in coronary artery bypass grafting and reconstructive procedures.
Area of Science:
- Anatomy
- Vascular Surgery
Background:
- The internal thoracic artery is vital for coronary artery bypass grafting and breast reconstruction.
- Knowledge of its anatomical variations is essential for surgical procedures.
Purpose of the Study:
- To investigate the origin, termination, and course of the internal thoracic artery.
- To document morphological features and variations for clinical application.
Main Methods:
- Study of 200 thoracic halves from 100 human cadavers.
- Analysis of internal thoracic artery origin, course, termination, and patterns.
Main Results:
- Origin: First part of the subclavian artery.
- Course: Predominantly medial concavity (88.5%), with 10% tortuous.
- Termination: Sixth intercostal space (93.5%), with bifurcation (98%) or trifurcation (2%).
Conclusions:
- Clinicians must be aware of internal thoracic artery anatomical characteristics and variations.
- This knowledge improves prognosis and reduces complications in cardiovascular and reconstructive surgeries.
Objectives:
The internal thoracic artery is a favored vessel for coronary artery bypass grafting and is utilized for breast reconstructive surgeries. Our study focuses on the origin, termination, and course characteristics of the internal thoracic artery. A comprehension of these morphological features and possible variations will definitely aid a clinician in appropriate harvesting of the artery for clinical procedures.
Materials And Methods:
200 thoracic halves (from 100 embalmed adult human cadavers of either sex) were obtained from the department of anatomy. The origin, course characteristics, termination levels, and patterns for the internal thoracic artery were studied.
Results:
The internal thoracic artery originated from the first part of subclavian artery. The most common course pattern observed was medial concavity (88.5%). In 10% of cases, a tortuous course was observed. No artery with lateral concavity or rectilinear course pattern was documented. The artery terminated in the sixth space in 93.5% of cases. In 98% of cases, bifurcation in termination was observed. Trifurcation in termination was also observed in 2% of cases. The average length of variant artery (third terminating branch) was documented to be 5.5 cm.
Conclusion:
The increased utilization of the internal thoracic artery for coronary bypass arterial surgery and its role in sternal wound healing has made it imperative for clinicians to keep in mind its anatomical characteristics and local variations. This knowledge definitely will improve prognosis and decrease intraoperative/postoperative complications in patients undergoing coronary surgeries, percutaneous subclavian catheterizations, and reconstructive procedures.
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