Surgical Anatomy of the Lateral Thoracic Artery and Its Perforators: A Computed Tomographic Angiography and Cadaveric Dissection Study

Abstract

Objective: This study explores the anatomical variations and characteristics of the lateral thoracic artery (LTA) and its perforators through thoracic computed tomographic angiographies (CTA) and cadaveric dissection, aiming to enhance surgical planning and patient outcomes. Materials and Methods: Data were recorded for both thoracic CTA patients (n = 40) and soft cadavers (n = 13) for subsequent retrospective analyses of biological sex, age, body mass index (BMI), LTA characteristics (length, diameter, origin, number of perforators, number of lymph nodes), and locations (rib level and distance from the pectoralis major, latissimus dorsi, and acromioclavicular joint). Results: Average LTA parameters for thoracic CTAs were 89.6 millimeters in length from origin and 2.1 millimeters in diameter, while cadavers were 117.0 millimeters in length and 2.3 millimeters in diameter. At least 1-2 cutaneousperforators and 1 proximal lymph node were found across both thoracic CTAs and cadavers. No significant differences were observed between the left and right sides for both groups. On average, 73.8% and 66.4% of LTAs from thoracic CTAs and cadavers, respectively, originated from the axillary artery. Conclusion: This knowledge is crucial for surgical planning, both to minimize damage to the LTA and ensure the inclusion of its perforators and proximal lymph nodes in the lateral thoracic region. The researchers recommend lateral thoracic artery perforator flap harvest between the lateral border of the pectoralis major and the anterior border of the latissimus dorsi, specifically above the 3rd-6th ribs, which is correlated to the length of LTA at 89.6-117 millimeters from origins.