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In human anatomy, the internal thoracic artery (ITA) (previously known as the internal mammary artery) is a vessel that supplies the chest wall and mamma, a term used for breast in anatomy.
The left ITA and the right ITA arise from the left and right subclavian arteries, shortly after their origins, and travels down the chest apporximately 1cm lateral to the sternum, but medial to the nipple. They give off branches to the anterior intercostal arteries, which anastomoses with the posterior intercostals arteries and originate from the thoracic aorta or superior intercostal arteries. After passing the sixth intercostal space, they each bifurcate into a musculophrenic artery (which roughly follows the coastal margin) and a superior epigastric artery, which each anastomose with an inferior epigastric artery that originates either from the left or right external iliac artery.
The ITA's branches as a list
- Two anterior intercostal arteries for the upper six intercostal spaces
- Perforating arteries, which accompany terminal branches of intercostal nerve
- Pericardiophrenic nerve, supplying the pericardium
- Mediastinal arteries
- Superior epigastric artery
- Musculophrenic artery
Revascularization with the ITA
The internal thoracic artery is the cardiac surgeon's blood vessel of choice for coronary artery bypass grafting. The left ITA has a superior long-term patency to saphenous vein graftsKitamura S, Kawachi K, Kawata T, Kobayashi S, Mizuguchi K, Kameda Y, Nishioka H, Hamada Y, Yoshida Y. survival and cardiac event-free rates in Japanese patients with the left anterior descending artery revascularized with internal thoracic artery or saphenous vein graft: a comparative study Nippon Geka Gakkai Zasshi. 1996 Mar;97(3):202-9. PMID 8649330.Arima M, Kanoh T, Suzuki T, Kuremoto K, Tanimoto K, Oigawa T, Matsuda S. Serial Angiographic Follow-up Beyond 10 Years After Coronary Artery Bypass Grafting. Circ J. 2005 Aug;69(8):896-902. PMID 16041156. Free Full Text. and other arterial graftsCohen G, Tamariz MG, Sever JY, Liaghati N, Guru V, Christakis GT, Bhatnagar G, Cutrara C, Abouzahr L, Goldman BS, Fremes SE. The radial artery versus the saphenous vein graft in contemporary CABG: a case-matched study. Ann Thorac Surg. 2001 Jan;71(1):180-5; discussion 185-6. PMID 11216742. (e.g. radial artery, gastroepiploic artery) when grafted to the left anterior descending coronary artery, generally the most important vessel, clinically, to revascularize.
References
External links
- - Internal thoracic artery
- - Anterior intercostal arteries
Figures of ITA grafts
- Figure of heart with two saphenous vein grafts (SVGs) and a LITA graft - texheartsurgeons.com
- Drawing of the heart with a SVG to the right coronary artery (RCA) and a LITA graft to the LAD - darcystudios.com
- Drawing of the heart with a SVG to the RCA and a LITA graft to the LAD - mayoclinic.org
"Internal thoracic artery"