Thoracodorsal Artery

arteria thoracodorsalis

The thoracodorsal artery is the continuation of the subscapular artery after it gives off the circumflex scapular branch, descending along the posterior axillary wall to supply the latissimus dorsi muscle. It enters the deep surface of the latissimus dorsi with the thoracodorsal nerve, and within the muscle it divides into medial and lateral branches that run parallel to each other and can be identified as pedicle landmarks for flap design.

Region: Chest

Clinical Relevance

Clinical Notes

The thoracodorsal artery is the dominant pedicle for the latissimus dorsi myocutaneous flap, one of the most versatile and commonly used reconstructive flaps in surgery. The latissimus flap is used for breast reconstruction after mastectomy, scalp and skull reconstruction, chest wall coverage, upper extremity coverage, and head and neck reconstruction. Preoperative assessment by Doppler or angiography maps the medial and lateral branches. The thoracodorsal artery is also the pedicle for the serratus anterior flap and thoracodorsal artery perforator (TAP) flap.

Pathology

Common Injuries & Conditions

Thoracodorsal Artery Injury from Prior Axillary Surgery

Previous axillary lymph node dissection, axillary radiation, or sentinel node biopsy may damage the thoracodorsal vessels, rendering the latissimus flap unreliable; preoperative Doppler assessment and angiography are essential before planning a latissimus flap in patients with prior axillary surgery.