Brachiocephalic Artery

What is the brachiocephalic artery?

Your brachiocephalic artery is a blood vessel that branches off your aorta in your upper chest. It’s the first branch of your aortic arch, which is the curved, top part of your aorta that resembles the rounded handle of a cane. Your brachiocephalic artery helps supply blood to the upper right side of your body.

Other names for your brachiocephalic artery include:

• Brachiocephalic trunk (because it’s the trunk, or base, of two major artery branches).
• Innominate artery.

Your brachiocephalic artery is part of your body’s circulatory system, which keeps blood moving throughout your body.

What does the brachiocephalic artery do?

Your brachiocephalic artery helps oxygen-rich blood reach organs and tissues in your upper body. It’s responsible for carrying blood from your aorta to your right subclavian artery and right common carotid artery. This blood supplies oxygen and nutrients to your upper right arm and the right side of your brain, face and neck.

Is the brachiocephalic artery oxygenated or deoxygenated?

Your brachiocephalic artery carries oxygenated (oxygen-rich) blood. Your heart pumps oxygen-rich blood into your aorta. From there, this blood travels into your aorta’s many branches (including your brachiocephalic artery) to nourish your body.

Where is the brachiocephalic artery located?

Your brachiocephalic artery (trunk) is located in the upper right side of your chest, above your heart and below your neck. It’s in the part of your chest known as your mediastinum. This is an important space that holds your heart and many other structures, including parts of major blood vessels.

Your brachiocephalic artery is the first branch off your aortic arch. “First” means it’s the branch of your aortic arch that’s nearest to your heart. However, your brachiocephalic artery isn’t the first branch off your aorta overall. That’s because leading up to your aortic arch is your ascending aorta, or the part of your aorta that curves upward from your heart. Your coronary arteries branch from your ascending aorta and supply blood to your heart muscle. So, your coronary arteries are the first branches off your aorta.

Your brachiocephalic artery isn’t one of the great vessels of your heart and doesn’t directly connect with a chamber of your heart. Rather, it’s a branch of your aorta.

What are the two main branches of the brachiocephalic artery?

As it travels upward, away from your heart, your brachiocephalic artery divides (bifurcates) into two branches:

• Right subclavian artery. This artery supplies blood to your upper right arm. It also gives rise to branches that supply blood to parts of your head, neck and chest.
• Right common carotid artery. This artery supplies blood to your brain and other structures in your head, face and neck.

These are called terminal branches because your brachiocephalic artery ends at this point. The location of this division (bifurcation) is near an anatomical landmark called the right sternoclavicular joint. This is the spot on the right side of your body where your clavicle (collarbone) and sternum (breastbone) join together.

How big is the brachiocephalic artery?

Your brachiocephalic artery (trunk) is generally 4 to 5 centimeters long. Its diameter ranges from 10.5 millimeters to 13.7 millimeters.

What is it made of?

Like your other arteries, your brachiocephalic artery has walls made of three layers:

• Tunica intima (interna). This is the innermost layer. It has a lining of endothelial cells that keep blood flowing smoothly through your artery.
• Tunica media. This is the middle layer. Smooth muscle cells that make up this layer help your artery widen or narrow as needed to control blood flow.
• Tunica adventitia (externa). This is the outermost layer. It gives your artery structure and support. Collagen and other connective tissues make up this layer.

What are the anatomic variations of the brachiocephalic artery?

Because your brachiocephalic artery branches from your aortic arch, aortic arch variations can affect its anatomy. The most common aortic arch variation that affects your brachiocephalic artery is a two-vessel branching pattern.

Normally, three blood vessels branch directly from your aortic arch. These are your:

• Brachiocephalic artery (trunk).
• Left subclavian artery.
• Left carotid artery.

With a two-vessel branching pattern, only two arteries branch from your aortic arch, rather than three. Two such patterns include:

• Common origin of the brachiocephalic artery and left common carotid artery. This means your brachiocephalic and left common carotid arteries arise from your aortic arch together, with a single, shared trunk. Your left subclavian artery arises separately as the second vessel (branch).
• Origin of the left common carotid artery from the brachiocephalic artery. This means your left common carotid artery branches from your brachiocephalic artery, rather than from a shared trunk arising from your aortic arch. Usually, the branching off point is about 1 centimeter from your aortic arch. Your left subclavian artery arises separately.

Is there a right brachiocephalic artery and a left brachiocephalic artery?

Most people only have one brachiocephalic artery, and it’s on the right side of their chest. However, some aortic arch variations may involve both a left and a right brachiocephalic artery, or just one on the left side.

What common conditions affect the brachiocephalic artery?

Conditions that may affect your brachiocephalic artery include:

• Tracheo-innominate fistula (TIF). A TIF is an abnormal connection between your windpipe (trachea) and your innominate (brachiocephalic) artery. It’s a life-threatening complication of a tracheostomy that leads to bleeding and requires emergency surgery. If you have a long-term tracheostomy, your healthcare provider may order computed tomography (CT) scans to check your risk for a TIF.
• Atherosclerosis. Atherosclerosis is the buildup of plaque in your arteries that may cause them to narrow over time, limiting blood flow to different parts of your body. When atherosclerosis affects blood flow to your brain (cerebrovascular disease), plaque buildup in your carotid arteries is usually the culprit. Rarely, though, plaque can narrow your brachiocephalic artery. If so, you may need treatment such as stent placement to improve blood flow.
• Aneurysm. An aneurysm is a weakness in your artery’s walls that causes a ballooning, or bulging, of the vessel. Aneurysms in your brachiocephalic artery are rare. They account for about 3 in 100 supra-aortic aneurysms (aneurysms that form in the arteries above your aortic arch).

How can I keep my brachiocephalic artery healthy?

There’s a lot you can do to help keep all of your arteries healthy. Tips include:

• Avoid tobacco use. This includes smoking, vaping and smokeless tobacco.
• Eat a heart-healthy diet low in saturated fat and sodium. Research shows the Mediterranean diet supports the health of your heart and blood vessels.
• Exercise regularly. Aim for 30 minutes of aerobic exercise at least five days per week.
• Keep a weight that’s healthy for you. Ask your healthcare provider about what your ideal weight should be, and how you can reach it.
• Limit alcohol consumption. This means no more than one drink per day for women and people assigned female at birth (AFAB) or two drinks per day for men and people assigned male at birth (AMAB).
• Manage stress. Learn new strategies to help you relax.
• Take your medications as your provider prescribes them. These include medications to manage cholesterol and blood pressure.
• Try to get enough sleep. Adults should aim for seven to nine hours of sleep per night to support heart health and overall health.
• Visit your healthcare provider. See your provider each year for regular check-ups, and keep all of your follow-up appointments.

A note from Cleveland Clinic

Learning the anatomy of your arteries — and other parts of your circulatory system — can be both intimidating and exciting. Whether you’re learning more due to a medical condition or simply out of interest, don’t hesitate to reach out to a healthcare provider with questions. Anatomy is complex and isn’t necessarily the same in every person’s body. So, drawing upon your provider’s knowledge can fill in gaps as you read and help you see the big picture.