Giriş: Arteria thoracica interna (ATI) ve vena thoracica interna (VTI) anatomik yerleşimleri nedeniyle koroner by-pass cerrahisinde ve meme rekonstrüksiyonlannda önemli yere sahiptir. Çalışmamızın amacı, cerrahi öneme sahip olan ATI ve VTI%in anatomik olarak incelenmesidir. Gereç ve yöntem: Çalışmamız formaldehit ile fikse edilmiş 10 erişkin insan kadavrasında gerçekleştirildi. Disseksiyon ile sternumvun her iki yaninda ATI ve VTI görünür hale getirilerek ölçümler yapıldı. Bulgular: ATFnın olguların %88,89vunda (16/18) iki dala ayrıldığı gözlendi. Ayrılma yeri 4. kostanın üst ucu (%12,50), 4. kostanin alt ucu (%6,25), 5. kostanin üst ucu (%6,25), 5. kostanin alt ucu (%43,75), 6. kostanin üst ucu (%31,75) olarak belirlendi. ATPnin ortalama çapı 2,58 mm (min-max: 2,00-3,20 mm), 5. interkostal aralık (IA)vda sternunTa ortalama uzaklığı 13,11 mm (min-max: 6,00-22,00 mm) olarak ölçüldü. VTI'nın olguların %94,44vünde (17/18) iki dala ayrıldığı gözlendi. Ayrılma yeri 1. kostanin alt ucu (%5,90), 2. kostanin üst ucu (%5,90), 2. kostanin alt ucu (%5,90), 2. IA (%17,65), 3. kostanin üst ucu (%23,50), 3. kostanin alt ucu (%5,90), 3. IA (%5,90), 4. kostanin üst ucu ( %11,72), 4. kostanin alt ucu (%5,90), 5. kostanin üst ucu ( %11,72) olarak belirlendi. VTFnin ortalama çapı 2. IA'da 3.12 mm (min-max: 1,90-5,00 mm), 3. IAV da 2,59 mm (min-max: 1,8-3,9 mm) olarak ölçüldü. Sonuç: ATI ve VTI hem proksimal hem de distal yönde gerçekleştirilecek anastomozlar için uygun özelliklere sahip damarlardır. Bu nedenle anatomik olarak iyi tanımlanmalarının klinik önemi büyüktür.
Introduction: Anatomic position of the internal mammary vessels is important in breast reconstruction and coronary artery myocardial revascularisation. Objective of this study was to describe detailed anatomy of the internal mammary vessels. Material and method: Dissection was performed in 10 formalin fixed human cadavers . After both of the clavicles were removed the anterior mammary wall was released by cutting it on both sides of the cadavers following the midaxillary line. The parietal pleura and endothoracic fascia were stripped on the posterior surface of the anterior thoracic wall and the transversus thoracis muscle was removed. The internal thoracic vessels were dissected. The diameter and distance of the vessels from the sternum were measured from the first intercostal space (ICS) to sixth ICS. The number, relationships and bifurcation points of the vessels were recorded.Results: The internal mammary (thoracic) artery IMA was divided into twc branches in 88.89% of all cases. The point of division occured at cranial edge of 4tr. r^b, at caudal edge of 4th rib, at the cranial edge of 5th rib, at caudal edge of 5th rib atNcaudal edge of 6th rib as 12.50%, 6.25%, 6.25%, 43.75%, 31.75% respectively Thepmean diameter of the IMA was mesaured as 2.58 mm (range 2.00-3.20 mm), and* the mean distance ofthe IMA to the sternum was measured as 13.11 mm (range 6.00-22 mm) at the 5th ICS. The IMV was divided into two branches in 94.44% (17/18) of |he cases. The point of division occured at the caudal edge of 1st rib (5.90%), at theifranial edge of 2nd rib (5.90%), at caudal edge of 2nd rib (5.90%), at 2nd ICS (17.65%), at cranial edge of 3rd rib (23.50%), at the caudal edge of 3rd rib (5.90%), at 3rd ICS (5.90%), at cranial edge of 4th rib (11.72%), at caudal edge of 4th rib (5.90%) and at cranial edge of 5th rib (%11.72). The mean diameter of the medial IMV was mesaured as 2.48 mm (range 1.9-3.4 mm) at the 2nd ICS, and 2.59 mm (range 1.8-3.9 mm) at the 3rd ICS. Conclusion: The internal mammary vessels can provide double recipient vessels (proximal and distal ends) for anastomoses to both the deep inf<ş|jMr epigastric artery and vein.
