From the Guidelines
The thoracic artery is not explicitly defined in the provided evidence, but based on general medical knowledge, it can be referred to as the internal thoracic artery or internal mammary artery, which plays a crucial role in supplying blood to the anterior chest wall and is often used in cardiac surgery. The internal thoracic artery originates from the subclavian artery and descends vertically behind the costal cartilages, about one centimeter from the edge of the sternum. Some key points about the thoracic artery include:
- It supplies blood to the anterior chest wall, including the sternum, ribs, and intercostal muscles, as well as the mammary glands in females.
- It has several branches that distribute blood to these structures.
- The left internal thoracic artery is often used as a graft vessel in coronary artery bypass grafting (CABG) due to its excellent long-term patency rates 1. However, the provided evidence primarily focuses on thoracic aortic aneurysms, which are caused by degenerative disease resulting in dilatation of the aorta, and are estimated to have an incidence of around 10.4 cases per 100 000 person-years 1. Risk factors for development of thoracic aortic aneurysms include hypertension, smoking, and chronic obstructive pulmonary disease, as well as several genetic syndromes with a predisposition for thoracic aortic aneurysms 1. In the context of thoracic aortic disease, the term "thoracic artery" may be confused with the thoracic aorta, which is a distinct anatomical structure. It is essential to note that the evidence provided does not directly address the definition or function of the thoracic artery, but rather focuses on thoracic aortic aneurysms and their management.
From the Research
Definition and Characteristics of the Thoracic Artery
- The thoracic artery, also known as the internal thoracic artery (ITA), is a vital blood vessel that plays a crucial role in coronary artery revascularization 2, 3.
- The ITA is considered the optimal conduit for surgical coronary artery revascularization due to its superior patency rates and minimal evidence of atherosclerotic changes 2.
- The ITA usually arises from the intrascalenic part of the subclavian artery, but variations in its anatomy can occur, including origination from the extrascalenic part of the subclavian artery 3.
Branches and Anatomy of the Thoracic Artery
- The ITA has several branches, including sternal, perforating, intercostal, and mediastinal branches, which supply circulation to the sternum and surrounding tissues 4.
- The branches of the ITA can be divided into two main groups: proper (solitary) branches and common trunks, with varying diameters and lengths 4.
- The distance between the ITA and the lateral margin of the sternal bone varies, with the artery being closest to the sternum in the first intercostal space and gradually moving away from the sternum in lower intercostal spaces 5.
Clinical Significance and Management of the Thoracic Artery
- The ITA is often used as a graft in coronary artery bypass grafting (CABG) procedures, and its anatomy and variations are crucial for successful surgical outcomes 2, 3.
- Subclavian artery stenosis (SAS) can affect the ITA and impact CABG procedures, with various diagnostic and management approaches available, including stenting and using the ITA as a "free" graft 6.
- The management of SAS prior to CABG is critical, with percutaneous and surgical options available, and the choice of approach depending on individual patient needs and circumstances 6.