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The brachiocephalic artery, brachiocephalic trunk, or innominate artery is an artery of the mediastinum that supplies blood to the right arm, head, and neck. [1] [2] It is the first branch of the aortic arch. [3] Soon after it emerges, the brachiocephalic artery divides into the right common carotid artery and the right subclavian artery. [4]
The common carotid artery is the large artery whose pulse can be felt on both sides of the neck under the jaw. On the right side it starts from the brachiocephalic artery (a branch of the aorta), and on the left side the artery comes directly off the aortic arch. At the throat it forks into the internal carotid artery and the external carotid ...
The proximal part of left subclavian is blocked (shaded artery). This prevents antegrade ("forward") flow to the left arm and left vertebral. As a result, flow in the left vertebral is retrograde ("backwards") towards the left arm. Flow to the brain and circle of Willis is via antegrade right and left carotid and right vertebral arteries. Specialty
During the operation, a median sternotomy is performed in order to expose and ligate the involved artery above and below the fistula. Division of the thymus and superior retraction of the innominate vein exposes the innominate artery. [5] The innominate artery should be debrided to healthy tissue and closed with a monofilament suture. [5]
Arterial tortuosity syndrome is an extremely rare congenital connective tissue condition disorder characterized by tortuosity, elongation, stenosis, or aneurysms in major and medium-size arteries including the aorta.
In a third variant, the brachiocephalic artery splits into three arteries: the left common carotid artery, the right common carotid artery and the right subclavian artery; this variant is found in an estimated 7% of individuals. [16] In rare cases, the thyroid ima artery, a variant artery supplying the thyroid gland may arise from the aortic arch.
The ligamentum arteriosum (arterial ligament), also known as Botallo's ligament, Harvey's ligament, and Botallo's duct, [1] is a small ligament attaching the aorta to the pulmonary artery. [ clarification needed ] It serves no function in adults but is the remnant of the ductus arteriosus formed within three weeks after birth .
Normal blood flow in the brachial artery is 85 to 110 milliliters per minute (mL/min). After the creation of a fistula, the blood flow increases to 400–500 mL/min immediately, and 700–1,000 mL/min within 1 month. A brachiocephalic fistula above the elbow has a greater flow rate than a radiocephalic fistula at the wrist.