WordNet

work as an intern; "The young doctor is interning at the Medical Center this year"
an advanced student or graduate in medicine gaining supervised practical experience (`houseman is a British term) (同)interne, houseman, medical intern
deprive of freedom; "During WW II, Japanese were interned in camps in the West"
happening or arising or located within some limits or especially surface; "internal organs"; "internal mechanism of a toy"; "internal party maneuvering"
occurring within an institution or community; "intragroup squabbling within the corporation" (同)intragroup
a major thoroughfare that bears important traffic
a blood vessel that carries blood from the heart to the body (同)arteria, arterial blood vessel

PrepTutorEJDIC

Independent Television Authority(英国)独立テレビジョン公社
(特に戦時中)〈人・船など〉‘を'強制収容する,抑留する
『内側の』,内部にある / 『国内の』(domestic) / 内からとる,内用の
胸の,胸部の
動脈 / (道路・水路・鉄道などの)勘線,(通信の)主チャンネル

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/08/01 16:52:03」(JST)

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In human anatomy, the internal thoracic artery (ITA), previously known as the internal mammary artery (a name still common among surgeons^{[citation needed]}), 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.

Course

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 internal intercostal muscles, but superficial to the transverse thoracic muscles.

It continues downward until it divides into the musculophrenic artery and the superior epigastric artery around the sixth intercostal space.

Branches

Mediastinal branches
Thymic branches
Pericardiacophrenic artery - travels with the phrenic nerve
Sternal branches
Perforating branches
Twelve anterior intercostal branches, two to each of the top six intercostal spaces. In a given space, the upper branch travelling laterally along the bottom of the rib until it anastomoses with its corresponding posterior intercostal artery. The lower branch of the space anastomoses with a collateral branch of the posterior intercostal artery.

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

Musculophrenic artery - roughly follows the costal margin
Superior epigastric artery - continues the course of the internal thoracic artery, travelling downward into the abdominal wall

Revascularization with the ITA

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^[1]^[2] and other arterial grafts^[3] (e.g. radial artery, gastroepiploic artery^{[disambiguation needed]}) 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 micro-vascular anastomosis is performed at the second intercostal space to the artery on which the free flap is based.

Additional images

Anterior Thoracic Wall, from behind
Diagram of an Intercostal Space
Posterior surface of sternum and costal cartilages, showing Transversus thoracis.
Transverse section of thorax, showing relations of pulmonary artery.
The axillary artery and its branches.
The right brachial plexus with its short branches, viewed from in front.
Diagram of the course and branches of a typical intercostal nerve. Labeled under its deprecated name the internal mammary artery.

References

^ Kitamura, S; Kawachi, K; Kawata, T; Kobayashi, S; Mizuguchi, K; Kameda, Y; Nishioka, H; Hamada, Y; Yoshida, Y (1996). "Ten-year survival and cardiac event-free rates in Japanese patients with the left anterior descending artery revascularized with internal thoracic artery or saphenous vein graft: a comparative study". Nippon Geka Gakkai zasshi 97 (3): 202–9. PMID 8649330.
^ Arima, M; Kanoh, T; Suzuki, T; Kuremoto, K; Tanimoto, K; Oigawa, T; Matsuda, S (2005). "Serial angiographic follow-up beyond 10 years after coronary artery bypass grafting". Circulation journal : official journal of the Japanese Circulation Society 69 (8): 896–902. doi:10.1253/circj.69.896. PMID 16041156.
^ Cohen, G; Tamariz, MG; Sever, JY; Liaghati, N; Guru, V; Christakis, GT; Bhatnagar, G; Cutrara, C et al. (2001). "The radial artery versus the saphenous vein graft in contemporary CABG: a case-matched study". The Annals of thoracic surgery 71 (1): 180–5; discussion 185–6. doi:10.1016/S0003-4975(00)02285-2. PMID 11216742.

External links

-502923206 at GPnotebook - Internal thoracic artery

Figures of ITA grafts

Figure of heart with two saphenous vein grafts (SVGs) and a LITA graft - texheartsurgeons.com
Drawing of the heart with a SVG to the right coronary artery (RCA) and a LITA graft to the LAD - darcystudios.com
Drawing of the heart with a SVG to the RCA and a LITA graft to the LAD - mayoclinic.org

UpToDate Contents

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1. 冠動脈バイパス術：長期的臨床転帰 coronary artery bypass graft surgery long term clinical outcomes
2. 冠動脈バイパス術：失敗の原因および割合 coronary artery bypass graft surgery causes and rates of graft failure
3. 多枝冠動脈病変を持つ糖尿病患者の冠動脈血行再建術 coronary artery revascularization in patients with diabetes mellitus and multivessel coronary artery disease
4. 低侵襲冠動脈バイパス術：定義および技術的な問題 minimally invasive coronary artery bypass graft surgery definitions and technical issues
5. 重大な冠動脈左前下行枝近位部病変のマネージメント management of significant proximal left anterior descending coronary artery disease

English Journal

Use of graft flow measurement and computerized tomography angiography to evaluate patency of endoscopically harvested radial artery as sequential graft in coronary artery bypass surgery.

Tsai FC1, Yeh TF, Jing Lin P.Author information 1Division of Thoracic and Cardiovascular Surgery Chang Gung Memorial Hospital, Linkou Center Chang Gung University College of Medicine Taiwan, Republic of China - lutony@cgmh.org.tw.AbstractAIM: Endoscopic radial artery (RA) graft harvesting in coronary artery bypass surgery (CABG) is attractive but concern remains regarding early graft failure. We evaluated RA graft patency via intraoperative graft flow measurements and mid-term computerized tomography angiography (CTA).
The Journal of cardiovascular surgery.J Cardiovasc Surg (Torino).2014 Jun;55(3):415-22. Epub 2013 Nov 28.
AIM: Endoscopic radial artery (RA) graft harvesting in coronary artery bypass surgery (CABG) is attractive but concern remains regarding early graft failure. We evaluated RA graft patency via intraoperative graft flow measurements and mid-term computerized tomography angiography (CTA).METHODS: The p
PMID 24284992

Direct implantation versus platelet-rich fibrin-embedded adipose-derived mesenchymal stem cells in treating rat acute myocardial infarction.

Sun CK1, Zhen YY2, Leu S3, Tsai TH2, Chang LT4, Sheu JJ5, Chen YL2, Chua S2, Chai HT2, Lu HI5, Chang HW6, Lee FY5, Yip HK7.Author information 1Department of Emergency Medicine, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan.2Division of Cardiology, Department of Internal Medicine, Taiwan.3Center for Translational Research in Biomedical Sciences, Taiwan.4Basic Science, Nursing Department, Meiho Institute of Technology, Pingtung, Taiwan.5Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.6Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.7Division of Cardiology, Department of Internal Medicine, Taiwan; Center for Translational Research in Biomedical Sciences, Taiwan. Electronic address: han.gung@msa.hinet.net.AbstractBACKGROUND: This study tested whether adipose-derived mesenchymal stem cells (ADMSC) embedded in platelet-rich fibrin (PRF) scaffold is superior to direct ADMSC implantation in improving left ventricular (LV) performance and reducing LV remodeling in a rat acute myocardial infarction (AMI) model of left anterior descending coronary artery (LAD) ligation.
International journal of cardiology.Int J Cardiol.2014 May 15;173(3):410-23. doi: 10.1016/j.ijcard.2014.03.015. Epub 2014 Mar 14.
BACKGROUND: This study tested whether adipose-derived mesenchymal stem cells (ADMSC) embedded in platelet-rich fibrin (PRF) scaffold is superior to direct ADMSC implantation in improving left ventricular (LV) performance and reducing LV remodeling in a rat acute myocardial infarction (AMI) model of
PMID 24685001

Can previous diagnostic examinations prevent preoperative angiographic assessment of the internal mammary perforators for (micro)surgical use?

Schellekens PP1, Aukema TS, Hage JJ, Prevoo W, Kon M.Author information 1From the *Department of Plastic and Reconstructive Surgery and Handsurgery at the University Medical Center Utrecht; and †Departments of Nuclear Medicine, ‡Plastic and Reconstructive Surgery, and §Radiology at the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.AbstractBACKGROUND AND AIM: Preoperative assessment of the internal mammary artery perforating (IMAP) branches enhances IMAP-based reconstructive procedures. Conventionally, color-flow Doppler, selective catheter arteriography, or CT angiography is used for such assessment. We studied how often these examinations may be rendered superfluous by assessment of previously performed diagnostic examinations.
Annals of plastic surgery.Ann Plast Surg.2014 May;72(5):560-5. doi: 10.1097/SAP.0b013e318268a896.
BACKGROUND AND AIM: Preoperative assessment of the internal mammary artery perforating (IMAP) branches enhances IMAP-based reconstructive procedures. Conventionally, color-flow Doppler, selective catheter arteriography, or CT angiography is used for such assessment. We studied how often these examin
PMID 23486113

Japanese Journal

Spontaneous Spiral Dissection of Left Internal Thoracic Artery Graft:Combined Assessment by Optical Coherence Tomography and Intravascular Ultrasound

, , ,
International Heart Journal 56(3), 360-362, 2015
… The left internal thoracic artery (LITA) is considered the most reliable coronary artery bypass grafting conduit due to its high rate of long-term patency. … We present a case with spontaneous spiral dissection of a LITA graft to the left anterior descending artery, which was assessed by optical coherence tomography (OCT) and intravascular ultrasound (IVUS). …
NAID 130005070024

Takayasu Arteritis and Ulcerative Cutaneous Sarcoidosis

, , , , , , , , , , , , , ,
Internal
… In addition to occlusion of the left subclavian artery and stenosis at the ostium of the right coronary artery, these findings led to a diagnosis of Takayasu arteritis. …
NAID 130005068303

左主幹部病変に対するOff-pump CABG を第一選択とする外科的血行再建の中長期成績

水野友裕,大井啓司,八島正文,八丸剛,渡邊大樹,黒木秀仁,藤原立樹,櫻井翔吾,酒井健司,荒井裕国
日本冠疾患学会雑誌 advpub(0), 2015
当院で行われた左主幹部病変を持つ症例に対する単独冠動脈バイパス術121 例(Off-pump 率89.3％)の術後成績を追跡し，SYNTAX trial(on-pump 率85％)の結果と比較検討した．平均末梢吻合枝数3.7 本，内胸動脈―左前下行枝バイパス(96.7％)で，術後5 年での全死亡率3.8％，心筋梗塞発生率5.0％，再血行再建率6.3％，脳合併症4.2％(周術期0％)，MACCE 発 …
NAID 130005067860

Related Pictures

★リンクテーブル★

リンク元	「内胸動脈」「mammary artery」「internal mammary artery」「ITA」
関連記事	「thoracic」「internal」「intern」「thoracic artery」

「内胸動脈」

Artery: Internal thoracic artery
	Anterior Wall of the Thorax, labeled at center.
	Right internal thoracic artery and its branches. (Labeled under its' old name the Internal mammary artery. at upper right.)
Latin	Arteria thoracica interna,; (arteria mammaria interna)
Gray's	p.583
Source	Subclavian artery
Branches	Pericardiophrenic; Anterior intercostal branches; Musculophrenic; Superior epigastric; Perforating branches
Vein	Internal thoracic vein
MeSH	Mammary+Arteries