Pectoral Branch of the Thoracoacromial Artery

ramus pectoralis arteriae thoracoacromialis

The pectoral branch of the thoracoacromial artery is the largest of the four thoracoacromial branches, running between the pectoralis major and minor to supply both muscles and the breast. It is the dominant blood supply to the pectoralis major medial and central portions.

Region: Shoulder

Clinical Relevance

Clinical Notes

The pectoral branch is the primary vascular pedicle preserved during pectoralis major flap elevation for chest wall and head-and-neck reconstruction. Identification and preservation of this branch during subpectoral breast augmentation is important to avoid pectoralis major devascularisation. In radical mastectomy, sacrifice of the pectoral branches devascularises the pectoralis major, which is now rarely performed. The pectoral branch accompanies the medial and lateral pectoral nerves in the pectoral fascia.

Pathology

Common Injuries & Conditions

Pectoralis Major Devascularisation

Loss of pectoral branch supply during aggressive subpectoral dissection producing pectoralis major atrophy and weakness, visible as anterior chest asymmetry and reduced shoulder adduction strength.