Costocervical Trunk

truncus costocervicalis

The costocervical trunk arises from the posterior aspect of the subclavian artery, just lateral to the thyrocervical trunk. It gives rise to two branches: the superior intercostal artery (which descends to provide the first and second posterior intercostal arteries) and the deep cervical artery (which ascends between the semispinalis capitis and semispinalis cervicis to supply the deep posterior cervical muscles and anastomose with branches of the occipital artery).

Region: Neck

Clinical Relevance

Clinical Notes

The costocervical trunk and its branches are relevant in posterior cervical and upper thoracic surgery, providing the blood supply to the deep extensor muscles of the neck. The superior intercostal artery supplies the critical T1-T2 intercostal space, relevant in thoracic outlet surgery and first rib resection. The deep cervical artery forms an important collateral pathway between the subclavian and vertebrobasilar systems, which can sustain vertebral artery flow in proximal subclavian occlusion.

Pathology

Common Injuries & Conditions

First Rib Resection Vascular Injury

During thoracic outlet decompression by first rib resection, the subclavian artery, vein, and the costocervical trunk branches at the first rib level are at risk from inadvertent injury or inclusion in the resection zone, requiring thorough anatomical knowledge and careful surgical technique.