The subclavian arteries are the two major arteries (right and left) that arise from the aortic arch and supply blood to the arms, neck, and parts of the brain. Each subclavian artery runs beneath the clavicle (collarbone) and continues distally as the axillary and then the brachial artery supplying the arm. The subclavian arteries also give rise to the vertebral arteries (supplying the brainstem and cerebellum) and the internal mammary arteries (also called internal thoracic arteries).
The internal mammary arteries are particularly important in cardiac surgery: they are the most durable conduit used in coronary artery bypass grafting (CABG), with patency rates significantly higher than saphenous vein grafts. After CABG, subsequent cardiac procedures must account for the presence of these bypassed arteries.
In critical care, the subclavian vein (running alongside the subclavian artery) is used for central venous catheter insertion. Subclavian artery stenosis can cause subclavian steal syndrome, where blood is diverted from the vertebral artery (and therefore the brain) to supply the arm. In aortic dissection, involvement of the subclavian arteries can produce differences in blood pressure between the two arms.
For patients who have undergone ICD or pacemaker implantation via the subclavian vein or cephalic vein (which drains into the subclavian), understanding this anatomy helps explain why the implanting shoulder may be restricted during recovery and why certain activities involving arm and shoulder movement may need to be limited initially.
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