Angiography of the Internal Mammary Artery

Abstract

The anatomy and catheterization techniques of the internal mammary artery (i.m.a.) are described. The diagnostic criteria and importance of i.m.a. angiography in thymoma, lymphoma, carcinoma, parathyroid adenoma, diseases of the breast, and trauma are discussed. The role of i.m.a. catheterization for i.a. infusion therapy in lung carcinoma, mesothelioma and chest wall metastases of breast carcinoma and embolization of i.m.a. in bleeding following trauma or tumour ulceration are described. Transcatheter treatment of mediastinal parathyroid adenoma is also described.

Prevention of paraplegia during thoracic aortic cross-clamping: Importance of patent internal mammary arteries

“…21 In fact, classic anatomic studies have demonstrated that in the entire adult human spinal cord, only 3 to 10 anterior, and 10 to 24 posterior RAs remain. lO RAs arise from subclavian artery branches, aortic ICAs, and lumbar arteries and are necessary for spinal cord viability.1O, 12,13 The largest RA, the arteria radicularis magnus, originates between T9 and T12 75% of the time. 4 ,14,22,23 This vessel is a necessary though not sufficient supply for the spinal cord 24 because it preferentially directs flow distally in the anterior spinal artery.…”

“…4 ,5 Anatomic and angiographic studies have clearly demonstrated that the internal mammary arteries (!MAs) supply the anterior intercostal arteries (ICAs) and connect with the posterior ICAs arising from the aorta. 12 , 13 The posterior ICAs then supply the thoracic spinal cord via radicular arteries (RA) ( Fig. 1) .…”

Traumatic Chest Wall Injuries

“…In case of arterial bleeding, there are several ways to manage the hemorrhage: selective angiographic embolization, US-guided hemostatic injection, and conservative management, such as compression [94]. When there's no injury of the great vessels, MDCT angiography often allows to detect bleeding from branches of the internal mammary artery, which can be embolized successfully with low complication rates [95].…”

Embolization Techniques in Trauma of the Chest

“…The IMA terminates into two end arteries, specifically the musculophrenic artery, which provides anastomotic branches to the lower posterior intercostal arteries, and the superior epigastric artery, which anastomoses with the inferior epigastric artery. [18][19][20] Injury to the IMA can occur as a result of blunt or penetrating trauma to the chest. Iatrogenic damage to the IMA is possible during anterior chest wall procedures, such as wire closure after median sternotomy.…”