Evaluation of morphometrics of the internal thoracic arteria by computed tomograpy

INTRODUCTION AND AIM: The arteria thoracica interna (ATI), also known as the internal mammary artery, is a branch of the subclavian artery, typically arising from its second part. It is usually bilaterally located with the accompanying veins and positioned medially along the lateral edge of the sternum. Due to its central location, the ATI is less affected by radiotherapy than other arteries, making it particularly important in breast surgery. The ATI is widely used in autologous free flap breast reconstruction due to its anatomical position, suitable diameter, and excellent cosmetic outcomes. Given its widespread use in various surgical procedures, preoperative imaging of both variations of the ATI is of great importance. Understanding its anatomical characteristics and morphometry provides valuable guidance for clinicians. Therefore, our study aimed to identify the anatomical features of the ATI, including its variations, origin level, length, and diameter. MATERIALS AND METHODS: In our study, we retrospectively evaluated thoracic computed tomographic angiography images obtained for various indications from 37 female and 35 male patients aged between 18 and 69 years at Sakarya University Training and Research Hospital. The anatomical and morphological characteristics of the ATI were examined in the imaging data. The measurements were statistically analyzed using SPSS software, and findings were obtained. RESULTS: According to our findings, the ATI length, diameters measured at the 1st to 6th intercostal space (ICS) levels, distances to critical anatomical landmarks, and the presence of perforating branches at ICS levels showed statistically significant differences based on gender and laterality (right/left side). CONCLUSION: A literature review reveals that most studies evaluating the ATI focus on a single parameter, such as length, diameter, or distance to key structures. In contrast, our study provides a more comprehensive dataset by collectively including all these morphometric parameters. Our findings will contribute meaningfully to both clinical practice and the existing body of literature. Keywords: Arteria Thoracica Interna, Arteria Subclavia, Computer Tomography, Morphometric measurement, Otologous Breast Reconstruction