Šaherl L Kocbek, Gosak M, Rakuša M
Institute of Anatomy, Histology and Embryology, Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000, Maribor, Slovenia.
Institute of Physiology, Faculty of Medicine, University of Maribor, Maribor, Slovenia.
Anat Sci Int. 2020 Sep;95(4):508-515. doi: 10.1007/s12565-020-00548-w. Epub 2020 May 20.
Morphological and anatomical characteristics of the posterior intercostal arteries have revived interest in their branching networks. Collateral supply between intercostal spaces is extensive due to anastomoses, although the data about the quantitative description of the branching networks in the existing literature are rather limited. The presence of collateral network between branches of the posterior intercostal arteries has been studied on forty-three Thiel-embalmed human cadavers. A network-based approach has been used to quantify the measured vascular branching patterns. Connections between branches of the same or adjacent posterior intercostal artery were identified. The non-anastomosing branches coursing in the intercostal spaces were also observed and their abundance was higher in comparison to anastomosing vessels. A quantitative analysis of collateral branching networks has revealed the highest density of vessels located close to the costal angle and most of the anastomosing branches were found between the fourth and tenth intercostal space. Anastomoses within the same posterior intercostal artery were more frequent in higher intercostal spaces, whereas in the lower intercostal spaces more connections were established between neighboring intercostal arteries. Our results indicate that due to abundant collateral contribution the possibility to cause an ischemic injury is rather low unless there is considerable damage to the blood supply of the trunk or surgical complication leading to ischemia or necrosis. Analyzing the proper course of collateral contributions of the posterior intercostal arteries may support further directions regarding the safest place for percutaneous transthoracic interventions, thoracocentesis, and lung biopsy.
肋间后动脉的形态学和解剖学特征重新引发了人们对其分支网络的兴趣。尽管现有文献中关于分支网络定量描述的数据相当有限，但由于吻合的存在，肋间间隙之间的侧支供应广泛。在43具经蒂尔固定的人体尸体上研究了肋间后动脉分支之间侧支网络的存在情况。已采用基于网络的方法对测量的血管分支模式进行量化。确定了同一或相邻肋间后动脉分支之间的连接。还观察到在肋间间隙走行的非吻合分支，与吻合血管相比，其数量更多。对侧支分支网络的定量分析显示，靠近肋角处血管密度最高，且大部分吻合分支位于第四至第十肋间间隙之间。同一肋间后动脉内的吻合在较高肋间间隙更频繁，而在较低肋间间隙，相邻肋间动脉之间建立的连接更多。我们的结果表明，由于丰富的侧支供血，除非主干血供受到相当大的损害或手术并发症导致缺血或坏死，否则造成缺血性损伤的可能性相当低。分析肋间后动脉侧支供血的正确路径可能有助于为经皮经胸介入、胸腔穿刺和肺活检的最安全部位提供进一步的指导方向。
