Brachiocephalic Artery: Function, Branches & Importance
The brachiocephalic trunk (innominate artery) is the first and largest branch of the aortic arch. It ascends rightward, bifurcating at the right sternoclavicular joint into:
- Right Common Carotid Artery: Supplies right brain (via internal carotid), face, scalp, neck.
- Right Subclavian Artery: Supplies right upper limb, chest wall, vertebral artery (posterior brain).
The left common carotid and left subclavian arise directly from the aortic arch as the 2nd and 3rd branches.
Clinical Significance
- Brachiocephalic occlusion: Right arm ischemia, right hemispheric stroke, syncope.
- Subclavian steal: Proximal subclavian stenosis → reversed vertebral flow → vertebrobasilar symptoms with arm exercise.
- Trauma: High risk in mediastinal injury.
- Surgery: Access for thoracic procedures; cannulation for cardiopulmonary bypass.
This short (4–5 cm) artery is critical for right-sided cerebral and upper extremity perfusion.
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