Relation of internal thoracic artery to lateral sternal border and its significance in clinical procedures

Abstract

1. ABSTRACT Knowledge of the anatomy of the internal thoracic vessels is important to avoid hemorrhagic complications, when an anterior parasternal approach is used for percutaneous transthoracic procedures such as biopsy and empyema drainage. In the present study 60 embalmed specimens of anterior thoracic walls were obtained from adult Indian cadavers of both sexes. The internal thoracic artery was carefully dissected. The distance of the artery from the edge of the sternum was measured in each intercostal space per hemisternum using the vernier calliper. Course of the internal thoracic artery per hemisternum was observed and recorded. Following findings were obtained, most common course of internal thoracic artery was rectilinear however in nearly one third of the cases it had a medial concavity. The distance of the internal thoracic artery from lateral sternal border was maximum at 2nd intercostal space followed by 3rd intercostal space, on both the sides. While performing parasternal percutaneous transthoracic procedure for biopsy and empyema drainage in 2nd intercostal space the approach should be greater than 18mm on right side and 17mm on left side from the sternal border, in order to avoid hemorrhagic complications due to injury to internal thoracic artery.