Subclavial artery

Structure of a subclavial artery

The subclavial artery represents the pair body consisting of the right and left subclavial arteries supplying with blood a hand and a neck.

It is a part of a big circle of blood circulation and originates in a front mediastinum: the right subclavial artery proceeds from a brachiocephalic trunk, being its final branch, left departs from an aortic arch. The left subclavial artery is longer than right: its intrathoracic part lies behind a brachiocephalic vein.

The direction of a subclavial artery in relation to an upper aperture of a thorax lies lateralno and up, forming a little convex arch which is bending around a top of a lung and a dome of a pleura.

Having reached the I edge, the subclavial artery comes into an interladder interval which is formed by adjacent surfaces of average and front scalenes. In the specified interval on it there is a brachial plexus.

Having rounded the I edge, the subclavial artery leaves under a clavicle and gets into an axillary cavity where is already called an axillary artery.

Distinguish three main departments of the left and right subclavial arteries:

• The first. Originates from the place of its education to an entrance to an interladder interval;
• The second. Begins in an interladder interval;
• The third. Begins at the exit from an interladder interval up to an entrance to an axillary cavity.

From the first department the following branches of a subclavial artery depart:

• Vertebral artery (a.vertebralis). Its way lies through a transverse foramen of the sixth cervical vertebra, rising up and entering a head cavity through foramenmagnum — a big occipital opening. Further she unites to an artery on the other hand, forming together with it a basilar artery. Function of a vertebral artery — to supply with blood a spinal cord, muscles and a firm cover of a brain (its occipital shares);

• The internal chest artery (a. thoracicainterna) originates from the lower surface of a subclavial artery. It supplies with blood with the nutrients dissolved in it a thyroid gland, primary bronchi, a diaphragm, a breast, a breast, fabric of a front and upper mediastinum, and also a breast and a direct muscle of a stomach;
• Shchitosheyny trunk (truncusthyrocervicalis). Departs from an inner edge of a scalene, reaching length about 1,5 cm, and it is subdivided into several branches which krovosnabzhat a mucous membrane of a throat, a muscle of a neck and a shovel.

The second department of a subclavial artery has only one branch: costal and cervical trunk (truncuscostocervicalis). It originates on the back surface of a subclavial artery and also is subdivided into several branches: a deep cervical artery and the highest intercostal artery from which also spinal branches depart back (the spins conducting to muscles).

Branch of the third department of a subclavial artery is the cross artery of a neck penetrating a brachial plexus and which is subdivided into the superficial artery supplying with blood of a muscle of a back, a deep branch of a subclavial artery and a dorsal artery of a shovel which falls up to a wide muscle of a back, feeding it and the accompanying small muscles.

Damages of a subclavial artery

Stenosis (narrowing of a gleam) – the basic disease affecting a subclavial artery and its branches.

Stenoses, most often, are a consequence of atherosclerotic changes in vessels or fibrinferment. Disturbances of exchange processes in an organism, inflammatory diseases and new growths are the reasons of the acquired (not inborn) stenosis of a subclavial artery.

The deposits on walls of vessels corking an artery have a lipidic basis, being, in fact, cholesterol derivatives.

Narrowing or the stenosis of a subclavial artery reducing about 80% of a gleam of a vessel leads to reduction of a volume blood-groove that results in very negative effect – short-reception by fabrics which krovosnabzhatsya from a subclavial artery, nutrients and oxygen.

The stenosis of arteries often is followed by emergence of the atherosclerotic plaques capable to completely block a blood flow in an artery and to increase probability of emergence of an ischemic stroke.

The main complaint of patients at a stenosis of a subclavial artery: the pain amplifying at exercise stresses, preferential on side of the affected extremity.

Treatment

The main methods of treatment of stenoses of subclavial arteries are:

• X-ray endovascular stenting;
• Sleepy and subclavial shunting.

Sleepy and subclavial shunting is carried out at patients of a hypersthenic constitution (at whom allocation of 1 department of a subclavial artery is accompanied by certain difficulties), and also at detection of a stenosis on the second department of a subclavial artery.

X-ray endovascular stenting has big advantages over open surgical intervention: operation is carried out under a local anesthesia through small (2-3 mm) a section on skin through a puncture opening.