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Anatomical variation in internal thoracic artery termination and sternal anomaly: implications for surgical and

Anand Verma1, Devendra Pal Singh1, Archishnu Vedanta Parida1

  • 1AIIMS, BHUBANESWAR, Bhubaneswar, India.

Folia Medica
|March 25, 2026
PubMed

Insights

Anatomical variations in the internal thoracic artery (ITA) and sternum are significant for surgical and interventional procedures. Recognizing these variations is crucial for patient outcomes in coronary artery bypass grafting and lung biopsies.

Area of Science:

  • Anatomy
  • Thoracic Surgery
  • Interventional Cardiology

Background:

  • The internal thoracic artery (ITA) is preferred for coronary artery bypass grafting (CABG) due to superior durability and patient outcomes compared to saphenous vein grafts.
  • Its anatomical features and intrathoracic course enhance its efficacy in cardiovascular procedures.
  • Accurate anatomical knowledge of the ITA is vital for percutaneous transthoracic interventions, including lung biopsies.

Purpose of the Study:

  • To report a rare cadaveric observation of an internal thoracic artery (ITA) termination variation.
  • To document an associated sternal anomaly.
  • To highlight the clinical significance of anatomical variations in thoracic procedures.

Main Methods:

  • Cadaveric dissection was performed.
  • Anatomical variations of the ITA and sternum were meticulously documented.

Main Results:

  • An unusual variation in the termination of the internal thoracic artery (ITA) was identified.
  • A concurrent sternal anomaly was observed in the same specimen.
  • These findings underscore the importance of detailed anatomical assessment.

Conclusions:

  • Anatomical variations, such as the observed ITA termination anomaly and sternal defect, can impact surgical and interventional strategies.
  • Awareness of such variations is critical for optimizing clinical decision-making and improving patient safety in thoracic interventions.
  • This case emphasizes the need for thorough pre-procedural evaluation to account for potential anatomical discrepancies.

Keywords:
CABG internal thoracic artery sternal anomaly

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