Internal thoracic artery


In human anatomy, the internal thoracic artery, previously known as the internal mammary artery, is an artery that supplies the anterior chest wall and the breasts. It is a paired artery, with one running along each side of the sternum, to continue after its bifurcation as the superior epigastric and musculophrenic arteries.

Structure

The internal thoracic artery arises from the subclavian artery near its origin.
It travels downward on the inside of the ribcage, approximately a centimeter from the sides of the sternum, and thus medial to the nipple. It is accompanied by the internal thoracic vein.
It runs deep to the external oblique, but superficial to the vagus nerve

Branches

After passing the sixth intercostal space, the internal thoracic artery splits into the following two terminal branches:

Use in bypass grafts

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 grafts and other arterial grafts when grafted to the left anterior descending coronary artery, generally the most important vessel, clinically, to revascularize.
Plastic surgeons may use either the left or right internal thoracic arteries for autologous free flap reconstruction of the breast after mastectomy. Usually, a microvascular anastomosis is performed at the second intercostal space to the artery on which the free flap is based.

Additional images

Figures of ITA grafts