Origin of the internal thoracic artery and its relationship to the phrenic nerves

Henriquez-Pino, Jorge; E, Mandiola-Lagunas; Prates, José Carlos

doi:10.1007/bf01629858

Cited by 7 publications

(2 citation statements)

References 4 publications

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“…Furthermore, it was found that the blood supply of the phrenic nerve on both sides of the ten corpses originated exclusively from the pericardiacophrenic artery, which is one branch of the ipsilateral internal thoracic artery. Henriquez-Pino et al (1993) reported that the distance between Fig. 4 Preferred positions of endoscopic instruments when performing dissection of the phrenic nerve, which is facilitated by placing the first thoracoscopic dissection clamp in the second or third intercostal space at the midclavicular line and the second in the second or third intercostal space 2 cm lateral to the parasternal line.…”

Section: Discussionmentioning

confidence: 99%

An anatomical study of the full-length phrenic nerve and its blood supply: clinical implications for endoscopic dissection

Shen

et al. 2011

Anat Sci Int

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For surgeries aimed at the dissection of full-length phrenic nerve, a full appreciation of its trajectory, blood supply and correlation with adjacent anatomical structures is necessary, especially for endoscopic manipulations. A fresh cadaver study was conducted with the purpose of avoiding surgical complications and ensuring further efficacy and efficiency of endoscopic manipulations. Ten fresh adult cadavers were dissected. Special attention was paid to the topography of the origin, the trajectory of the phrenic nerve, and its anatomic communication with the surrounding vessels and organs. In the second side of the cadavers, thoracic endoscopic manipulations and observations were also performed. The full length of the phrenic nerve was 24.6 ± 1.7 and 30.6 ± 1.8 cm on the right and left side, respectively; the blood supply of the phrenic nerve in the thoracic cavity came exclusively from the pericardiacophrenic artery; the distance between the origin of the pericardiacophrenic artery and that of the internal thoracic artery ranged from 0.5 to 5.2 cm on the right side, and from 1.4 to 5.6 cm on the left; most of the pericardiacophrenic veins intermingled with small vessels of pericardium and pleura, forming a venous network and joining the innominate vein. Endoscopic dissection of the thoracic phrenic nerve together with the accompanying pericardiacophrenic artery can be performed. Extreme attention should be paid during surgery to a section of about 6 cm in length of the artery originating from the internal thoracic artery, while the accompanying veins do not require to be spared.

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Section: Discussionmentioning

confidence: 99%

An anatomical study of the full-length phrenic nerve and its blood supply: clinical implications for endoscopic dissection

Shen

et al. 2011

Anat Sci Int

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“…In humans the ITA shows different origin from the subclavian artery, even indirect, via a common trunk with other branches (Bean, 1905;Henriquez-Pino et al, 1993. In humans a different origin could be analogous to that normal in some mammals, but, to our knowledge, this was not proved.…”

Section: Discussionmentioning

confidence: 65%

Lateral costal artery: Accessory thoracic vessel of clinical interest

et al. 2004

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The lateral costal artery (LCA), a supernumerary branch of the internal thoracic artery (ITA), occurs in several ethnic groups on one side of the thorax or on both, in 15-30% of cases. It has been considered responsible for the "steal-syndrome" of the coronary blood after coronary artery bypass grafting and it used occasionally for myocardial revascularization. To clarify its functional significance, an interpretation based on our findings and human and comparative anatomy and embryology has been attempted. We report on a case where a right LCA of about 2 mm in caliber, rising from the ITA 2.5 cm below the subclavian, coursed as far as the 4th intercostal space for a distance of 13 cm after the anterior axillary line. Anastomosing with the intercostal arteries, it can act as a blood derivative circuit of the thoracic wall. Embryologically, this artery, like the normal parietal arteries of the trunk, might form a longitudinal channel connecting the intersegmental arteries. In mammals having a thoracic cage transversely restricted (quadrupeds), the ITA is more lateral than in primates having a circular thorax, and gives off a ventral branch toward the sternum. It might be hypothesized that the sternal branch occurring in quadrupeds, undergoing adaptation to the thoracic shape of primates, may become the main trunk of the ITA, whereas the LCA may be the remnant of the ITA of quadrupeds. Because the LCA ran partly along the "milk line" of humans, it might be regarded as a supernumerary mammary artery.

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Coronary Bypass Grafts

Berdajs

Turina

2011

Operative Anatomy of the Heart

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Origin of the internal thoracic artery and its relationship to the phrenic nerves

Cited by 7 publications

References 4 publications

An anatomical study of the full-length phrenic nerve and its blood supply: clinical implications for endoscopic dissection

An anatomical study of the full-length phrenic nerve and its blood supply: clinical implications for endoscopic dissection

Lateral costal artery: Accessory thoracic vessel of clinical interest

Coronary Bypass Grafts

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