Comprehensive CT Angiography Assessment of Internal Thoracic Artery Morphometry, Anatomical Relationships, and Perforating Branches

Background and Objectives: The internal thoracic artery (ITA) is widely used in coronary artery bypass grafting and reconstructive procedures due to its favorable anatomical characteristics. This study aimed to comprehensively evaluate the morphometric features of the ITA using computed tomography angiography and to investigate variations according to sex and anatomical side. Materials and Methods: In this retrospective cross-sectional study, thoracic computed tomography angiography images of 72 individuals were analyzed. Bilateral measurements of ITA length, diameter at different intercostal levels, anatomical relationships, and perforating branches were recorded. Results: The mean ITA length was slightly greater on the left side (18.6 ± 2.7 cm) compared to the right (18.3 ± 2.3 cm), without significant sex differences. A progressive decrease in arterial diameter from proximal to distal segments was observed. Statistically significant sex-related differences in diameter were identified, particularly at the 3rd and 4th intercostal spaces (p < 0.05). Distances to adjacent anatomical structures also varied significantly between sexes. Perforating branches were most frequently detected at the 4th intercostal space. Conclusions: The ITA demonstrates notable morphometric variability depending on sex and anatomical side. These findings provide anatomical reference data that may contribute to individualized evaluation of the ITA.