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A thyroidea ima artery variation providing collateral circulation to the mediastinum

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Abstract

The thyroidea ima artery (TIA) is a highly variable arterial deviation of the blood supply to the thyroid gland with critical implications for surgical neck procedures such as tracheostomy. Though relatively common in the population at large (~ 4%), most TIA variations are related to the origin of the artery and whether it emerges from the common sites of the brachiocephalic trunk, aortic arch, and right common carotid artery, or another more unique vessel—as opposed to its dispersion pattern. TIA variants generally supply the thyroid gland, occasionally co-occurring with absent thyroid arteries. Here, we report on a unique case of a four-pronged variation of the TIA discovered during an anatomy laboratory dissection of first-year medical students. This variant originated from the brachiocephalic trunk and had three branches terminating in the thyroid gland and a fourth branch traveling into the thorax to provide accessory circulation in the mediastinum. Specifically, small arterial branches from the inferior TIA branch supplied the anterior pericardium and surrounding adipose tissue, in addition to normal pericardiacophrenic circulation. We discuss the potential embryological and clinical relevance of this unique variation and voice further support for imaging as a requirement before surgical neck procedures to prevent catastrophic bleeding in the event of a TIA variant.

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Data availability

All physical donor remains were returned to the University of Minnesota Anatomical Bequest Program in October of 2021, however, anonymized photographic and written data can be made available to researchers.

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Acknowledgements

This research was supported by funding from the Medical Student Summer Research Program of the Whiteside Institute for Clinical Research at the University of Minnesota Medical School, Duluth Campus. Additionally, the authors sincerely thank those who donated their bodies to science so that anatomical research could be performed. Results from such research can potentially increase overall knowledge that can then improve patient care. Therefore, these donors and their families deserve our highest gratitude. We specifically thank this donor for her selfless donation to the continued education of medical students. Additionally, we would like to thank Catherine Eisenreich, Jace Leslie, Sarah Reichhoff, Alyssa Welle, Brandon Haugrud, Elisabeth Poskie, William Sieling, and Dexter Yellowman for allowing us to utilize their donor in this study and for bringing this unique variation to our attention during dissection. We also thank Dr. Sandra Stover for providing the lighted speculum equipment used in this dissection.

Funding

This research was supported by funding from the Medical Student Summer Research Program of the Whiteside Institute for Clinical Research at the University of Minnesota Medical School, Duluth Campus.

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Authors and Affiliations

  1. Department of Biomedical Sciences, University of Minnesota Medical School Duluth Campus, 205 Smed 1035 University Dr, Duluth, MN, 55801, USA

    Taylor Benedict, Sharon Kuo, Natasha A. J. Adams, Therese Ach, Robin Michaels & Alexandra J. Zachwieja

  2. Technological Primates Research Group, Max Planck Institute for Evolutionary Anthropology, Deutscher Platz 6, 04103, Leipzig, Germany

    Sharon Kuo

Authors
  1. Taylor Benedict
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  2. Sharon Kuo
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  3. Natasha A. J. Adams
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  4. Therese Ach
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  5. Robin Michaels
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  6. Alexandra J. Zachwieja
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Contributions

TB was responsible for contributing to dissection, data collection, manuscript preparation and writing. SK contributed to the visualization of the figures. NA contributed to manuscript preparation and writing. TA and RM contributed to dissection as well as data collection. AZ contributed to and oversaw project development, dissection, data collection, manuscript writing and editing.

Corresponding author

Correspondence to Alexandra J. Zachwieja.

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The authors have no conflicts of interest to report.

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This study is exempt from the University of Minnesota IRB as it utilizes a non-living subject, but has been approved by the University of Minnesota Medical School Anatomy Bequest Program where all permissions for this research and consent for sharing images were obtained.

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The donor has an image use consent form on file with the University of Minnesota Medical School Anatomy Bequest Program.

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Benedict, T., Kuo, S., Adams, N.A.J. et al. A thyroidea ima artery variation providing collateral circulation to the mediastinum. Surg Radiol Anat 46, 507–512 (2024). https://doi.org/10.1007/s00276-024-03306-z

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  • DOI: https://doi.org/10.1007/s00276-024-03306-z

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