Cowher Abigail E, Bertus Brooke E, Lambert H Wayne, Zdilla Matthew J
Department of Pathology, Anatomy, and Laboratory Medicine (PALM), West Virginia University School of Medicine, Morgantown, WV, 26506, USA.
Department of Dermatology, West Virginia University School of Medicine, Morgantown, WV, Virginia, USA.
Surg Radiol Anat. 2025 Jan 24;47(1):62. doi: 10.1007/s00276-025-03574-3.
The unique structure and location of the internal thoracic artery make it an ideal conduit for coronary artery bypass grafting surgery and autologous breast reconstruction. Variants with different characteristics have the potential to impact surgical success. This report presents a female body donor with a novel bilateral variation of the internal thoracic artery. The vessel arose from third segment of the subclavian artery, distal to it coursing deep to the anterior scalene muscle, and then proceeded to course anterior to the first rib, instead of posteriorly. This variation could detract from the desirability of the internal thoracic artery as a graft. Tractioning the artery over the first rib may render it too stenotic for surgical utility. In an individual who has undergone autologous breast reconstruction, this variation may prohibit adequate length preservation for use in subsequent coronary artery bypass grafting. Also, in the setting of thoracic outlet syndrome, this arterial variation may cause unforeseen complications post-grafting.
胸廓内动脉独特的结构和位置使其成为冠状动脉搭桥手术及自体乳房重建的理想管道。具有不同特征的变异可能会影响手术成功率。本报告展示了一名女性尸体供者，其胸廓内动脉存在一种新的双侧变异。该血管起源于锁骨下动脉第三段，在其远端向深层走行于前斜角肌后方，然后继续在前第一肋前方走行，而非在后方。这种变异可能会降低胸廓内动脉作为移植物的适用性。在第一肋上方牵拉该动脉可能会使其狭窄到无法用于手术。在已接受自体乳房重建的个体中，这种变异可能会妨碍保留足够的长度以供后续冠状动脉搭桥手术使用。此外，在胸廓出口综合征的情况下，这种动脉变异可能会在移植后引发不可预见的并发症。
