Internal thoracic vein

Structure

Bilaterally, the internal thoracic vein arises from the superior epigastric vein, and accompanies the internal thoracic artery along its course. It drains the intercostal veins, although the posterior drainage is often handled by the azygous veins. It terminates in the brachiocephalic vein. It has a width of 2-3 mm.

There is either one or two internal thoracic veins accompanying the corresponding artery (internal thoracic artery). If internal thoracic vein is single, it usually runs medial to the artery. If there are double thoracic veins, they run on either side of the internal thoracic artery.

Variations

Bifurcation of each internal thoracic vein is common. The left internal thoracic vein may bifurcate between ribs 3-4 or remain as a single vein. The right internal thoracic vein may bifurcate between ribs 2-4 or remain as a single vein.

Function

The internal thoracic vein drains the chest wall and the breasts.

Clinical significance

Knowledge on the course of internal thoracic vein and artery is important during interventional procedures through the anterior chest wall such as biopsy and empyema drainage. This is to avoid puncturing the vessels and cause massive bleeding.

Accidental placement of central venous catheter in the internal thoracic vein can cause pleural effusions, chest wall abscess, pulmonary edema, shortness of breath and chest pain.

Other animals

Internal thoracic vein runs just lateral to the sternum.

The internal thoracic vein can act as a collateral circulation for blood from the inferior vena cava to the superior vena cava. This can work in either direction. It may partially compensate for disturbances to blood flow.

Additional images

File:Gray503.png|Transverse section of thorax, showing relations of pulmonary artery.

References

References

1. Drake, Richard L.. (2005). "Gray's anatomy for students". Elsevier/Churchill Livingstone.
2. (2007). "CHAPTER 2 - Venous Embryology and Anatomy". Academic Press.
3. (2009). "CHAPTER 18 - Deltopectoral flap". W.B. Saunders.
4. (1996). "Unutrasnji grudni krvni sudovi (a. et vv. thoracicae internae) i njihov prakticni znacaj". Srpski Arhiv Za Celokupno Lekarstvo.
5. (2019). "Structural, functional and molecular dynamics analysis of ''cathepsin B gene'' SNPs associated with tropical calcific pancreatitis, a rare disease of tropics". PeerJ.
6. Vollala, Venkata Ramana. (March 2008). "Internal thoracic vein draining into the extrapericardial part of the superior vena cava: a case report". Jornal Vascular Brasileiro.
7. (September 2020). "Internal thoracic veins: Anatomy, plasticity and clinico-imaging relevance in small animal practice". The Journal of Veterinary Medical Science.