Thyroidea ima artery multiple branching pattern over the trachea

PURPOSE: The current cadaveric report describes a rare case of a thyroidea ima artery (TIA) with multiple branching pattern over the trachea. METHODS: A cadaver dissection of the neck and thorax region of a formalin-embalmed 90-year-old male cadaver of a body donor took place. The body donation was made after a signed informed consent. RESULTS: The TIA variant originated from the brachiocephalic artery before its bifurcation into the right common carotid artery (CCA) and right subclavian artery (SCA). TIA further divided into three anterior and two posterior branches, with subsequent multiple division into smaller branches. All branches were located anterior and right side to the trachea. The anterior branches supplied the infrahyoid muscles and the posterior ones supplied the thyroid gland inferior lobes and the inferior parathyroid glands. The TIA coexisted with a brachiocephalico-carotid trunk, derived after the left CCA and brachiocephalic artery fusion. CONCLUSION: The presence of multiple arterial branches over the trachea creates a high risk for excessive bleeding during tracheotomy or cricothyroidotomy.