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Anatomy Atlases: Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Arteries: Head, Neck, and Thorax: Supreme (Superior) Intercostal Artery

Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Arteries: Head, Neck, and Thorax

Supreme (Superior) Intercostal Artery

Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD

Peer Review Status: Internally Peer Reviewed

This artery may be a branch of the vertebral, in which case it passes through the transverse foramen of the seventh cervical vertebra and between the ribs and transverse processes of the upper three intercostal spaces.

The supreme intercostal may arise from the costocervical trunk, thyrocervical trunk, deep cervical (cervicalis profundus), inferior thyroid, second intercostal, or axillary. The left artery has been reported as a branch of the aortic arch in cases having four arch branches.

In one case it arose from a lateral internal thoracic artery.

It may be absent, multiple, or diminished in size; in the latter case, it supplies only the first intercostal space.


Distribution of 60 arteries

1st Intercostal Space

1st & 2nd Spaces

2nd & 3rd Spaces

Number of Cases





Anson, B.J., Ed. (1966) Morris' Human Anatomy, 12trh ed., The Blakiston Division, McGraw-Hill Book Company, New York.

Bergman, R.A., Thompson, S.A., Afifi, A.K. and F.A. Saadeh. (1988) Compendium of Human Anatomic Variation: Catalog, Atlas and World Literature. Urban & Schwarzenberg. Baltimore and Munich.

Bühler, A. (1904) Varietat der ersten fünf Intercostalarterien. Gegenbaurs Morphologisches Jahrbuch 32:189-194.

Dankmeijer, J. et H.A. Snullen (1956) Systeme collateral dans la coarctation de l'aorte. Comptes Rendus Assoc. Anatomistes 43:259.

Ennable, E. (1966) L'artère intercostale supérieure. Arch. Anat. Path. 14:98-103.

Ernst, P. (1899) Zeitschr. für Morphol. und Anthropol. 1:495-506.

Grzybiak, M., Szostakiewicz-Sawicka, H. and A. Treder. (1975) Remarks on pathways of drainage from the left upper intercostal spaces in man. Folia Morphologica, Warsaw. 34:301-313.

Hovelacque, A. Anatomie Medico-Chirurgical du Thorax. Maloine éd., Paris.

Latarjet, M. and G. Braillon. (1965) Tronc artériel cervico-intercostal. Comptes Rendus Assoc. Anatomistes 49:983.

Nizankowski, C., Noczynski, L. and E. Suder. (1982) Variability of the origin of ramifications of the subclavian artery in humans (studies on the Polish population). Folia Morphologica, Warsaw 41:281-294.

Pensa, A. (1905) Osservazioni sulla morfologia e sullo sviluppo della arteria intercostalis suprema e delle arteriae intercostales. Bollettino della Societa Medico-Chirurgica, Pavia 1:48-83.

Poynter, C.W.M. (1916) Arterial anomalies pertaining to the aortic arches and the branches arising from them. The University Studies of the University of Nebraska, Lincoln 16:229-345.

Poynter, C.W.M. (1922) Congenital anomalies pertaining to the arteries and Veins of the Human Body with Bibliography. The University Studies of the University of Nebraska, Lincoln 22:1-106.

Walsham, W.J. (1882) Abnormal origin and distribution of the upper seven right intercostal arteries, with remarks. J. Anat. Physiol. 16:444-445.

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