Loukas M, Tobola M S, Tubbs R S, Louis R G, Karapidis M, Khan I, Spentzouris G, Linganna S, Curry B
Department of Anatomical Sciences, St. George's University, Grenada, West Indies.
Folia Morphol (Warsz). 2007 Feb;66(1):25-32.
The branching pattern and adequacy of the internal thoracic veins (ITV) are important factors, providing useful information on the availability of vessels and their appropriateness as an option for anastomoses in plastic and reconstructive surgery. During 100 cadaveric examinations of the anterior thoracic wall it was observed that ITVs were formed by the venae commitantes of ITAs, which united to form a single vein (one for the right side and one for the left) draining into the right and left brachiocephalic veins. The tributaries of ITVs corresponded to the branches of ITA. The right internal thoracic vein bifurcated at the 2(nd) rib in 36% of the specimens, at the 3(rd) rib in 30% of the specimens, at the 4(th) rib in 10% of the specimens and in 24% of the specimens it remained a single vein. The left internal thoracic vein bifurcated at the 3(rd) rib in 52% of specimens, at the 4(th) rib in 20% of specimens and in 28% of the specimens it remained as a single vein. In addition, it was observed that in 78% of specimens ITVs were connected to each other by a venous arch. This arch displayed four distinct morphologies: transverse (n = 7), oblique (n = 16), U-shaped (n = 51) and double-arched (n = 4). All 78 arches were posterior to the xiphisternal joint and no artery accompanied them. In the remaining specimens, RITV and LITV exhibited a venous plexus formation. The distance from the sternum to ITV gradually decreased as the vessel passed caudally; the diameter of the vessel similarly decreased along the vein's caudal course. The frequent appearance of two concomitant veins on both sides of the thorax may offer the opportunity to reduce venous congestion by two vein anastomoses. More detailed knowledge of the anatomy of ITV may prove useful in planning surgical procedures in the anterior thorax in order to avoid unexpected bleeding.
胸廓内静脉（ITV）的分支模式和充足性是重要因素，可为血管的可用性及其作为整形和重建手术中吻合选择的适宜性提供有用信息。在对100具尸体的胸壁前部进行检查时发现，胸廓内静脉由胸廓内动脉的伴行静脉形成，这些伴行静脉汇合形成一条单一静脉（右侧一条，左侧一条），汇入左右头臂静脉。胸廓内静脉的属支与胸廓内动脉的分支相对应。右侧胸廓内静脉在36%的标本中于第2肋处分支，在30%的标本中于第3肋处分支，在10%的标本中于第4肋处分支，24%的标本中仍为单一静脉。左侧胸廓内静脉在52%的标本中于第3肋处分支，在20%的标本中于第4肋处分支，28%的标本中仍为单一静脉。此外，还观察到78%的标本中胸廓内静脉通过静脉弓相互连接。该静脉弓呈现四种不同形态：横行（n = 7）、斜行（n = 16）、U形（n = 51）和双弓（n = 4）。所有78个静脉弓均位于剑胸结合后方，且无动脉伴行。在其余标本中，右侧胸廓内静脉和左侧胸廓内静脉呈现静脉丛形成。随着血管向尾侧走行，从胸骨到胸廓内静脉的距离逐渐减小；血管直径沿静脉的尾侧走行也同样减小。胸部两侧频繁出现两条伴行静脉可能提供了通过双静脉吻合减少静脉淤血的机会。更详细了解胸廓内静脉的解剖结构可能有助于在前胸部手术规划中避免意外出血。
