Origin and incidence of xiphoid branch of the internal thoracic artery

The study presents the incidence of a variant terminal branch of the internal thoracic artery (ITA). The ITA’s were cannulated in situ, injected with coloured latex and dissected together with its branches in 62 cadavers. Unlike the usual termination of the ITA bifurcating into the musculophrenic and superior epigastric arteries, this third branch arose from the medial border of the ITA at the level of the 6th costal cartilage. As it descends it inclines medially towards the angle between the xiphoid process and the 7th costal cartilage, giving off 2 or 3 fine branches to the lower sternum. It then passes deep to this angle and can be observed on the anterior surface of the xiphoid process, terminating in fine branches distributed to the inferior aspect of the xiphoid cartilage. It is proposed that this branch at the “trifurcation” of the ITA be termed the xiphoid branch. This branch was noted in 61.3%. An incidence of 30.7% was seen on the right and 21% on the left with bilateral presence in 9.7%. The xiphoid branch contributes to the supply to the lower sternal region and may be of special importance when the collateral supply to the region is compromised in the event of the internal thoracic or superior epigastric artery damage or when used as a conduit in coronary artery by-pass grafts.