CT Angiography Analysis of Axillary Artery Diameter versus Common Femoral Artery Diameter: Implications for Axillary Approach for Transcatheter Aortic Valve Replacement in Patients with Hostile Aortoiliac Segment and Advanced Lung Disease

Figure 4

Review of axillary artery anatomy with preferred access site being medial to the lateral thoracic artery. Source: see [19]. Axillary artery is divided into three branches based on its location relative to the pectoralis minor muscle. The first, second, and third parts are medial, posterior, and lateral to the pectoralis minor muscle, respectively. The branches of the axillary artery supply the arm and the muscles of thorax and scapular region and this region is well collateralized providing circulation to the arm from arteries that arise from dorsal and suprascapular artery. Given the abundance of collateral circulation, axillary artery can be and is used for arterial cannulation during cardiac surgery, without endangering the circulation to the arm, especially if the access point is medial to the origin of the lateral thoracic artery, given its anastomosis with the intercostal and the internal mammary artery.