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J Reconstr Microsurg 2013; 29(08): 531-536
DOI: 10.1055/s-0033-1351354
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Anatomic Variations in Branching Patterns of the Axillary Artery: A Multidetector-Row Computed Tomography Angiography Study

Yasunori Hattori
1   Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan
2   Department of Orthopedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi, Japan
,
Kazuteru Doi
1   Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan
,
Soutetsu Sakamoto
2   Department of Orthopedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi, Japan
,
Nilesh Satbhai
2   Department of Orthopedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi, Japan
› Author Affiliations
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Publication History

26 January 2013

07 June 2013

Publication Date:
24 July 2013 (online)

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Abstract

Anatomic variations in branching pattern of axillary artery (AxA) are common and typically involve subscapular artery (SsA) and posterior circumflex humeral artery (PCHA). Several skin and muscle flaps are based on the branches of AxA. Furthermore, these branches are frequently used as recipient vessels in functioning free muscle transfers for upper extremity reconstruction and in breast reconstruction. Accurate knowledge of the normal anatomy and variations in branching pattern of AxA is of significant clinical importance for the reconstructive microsurgeon. The purpose of this article is to report the variable branching pattern of AxA based on multidetector-row computed tomography angiography study of 62 upper extremities. The thoracoacromial artery consistently originated from the first or second part of AxA. The classic origin and branching patterns of SsA and PCHA were observed in 21 cases (33.9%). Anatomic variations of SsA and PCHA were observed in 41 upper extremities (66.1%). In addition to the classic pattern, five distinct variations were noted.

Keywords

axillary artery - subscapular artery - thoracoacromial artery
 

  • References

  • 1 Huelke DF. Variation in the origins of the branches of the axillary artery. Anat Anz 1959; 135: 33-41
    PubMedSearch in Google Scholar
  • 2 Rowsell AR, Davies DM, Eisenberg N, Taylor GI. The anatomy of the subscapular-thoracodorsal arterial system: study of 100 cadaver dissections. Br J Plast Surg 1984; 37 (4) 574-576
    CrossrefPubMedSearch in Google Scholar
  • 3 Maral T, Celik H, Hayran M, Kecik A. An anatomical variation of the thoracodorsal artery with comments on flaps based on the axillary artery. Eur J Plast Surg 1993; 16: 231-233
    PubMedSearch in Google Scholar
  • 4 Aizawa Y, Ohtsuka K, Kumaki K. Examination on the courses of the arteries in the axillary region I. The course of the subscapular artery system, especially the relationships between the arteries and the posterior cord of the brachial plexus. Kaibogaku Zasshi 1995; 70 (6) 554-568
    PubMedSearch in Google Scholar
  • 5 Durgun B, Yücel AH, Kizilkanat ED, Dere F. Multiple arterial variation of the human upper limb. Surg Radiol Anat 2002; 24 (2) 125-128
    CrossrefPubMedSearch in Google Scholar
  • 6 Saeed M, Rufai AA, Elsayed SE, Sadiq MS. Variations in the subclavian-axillary arterial system. Saudi Med J 2002; 23 (2) 206-212
    PubMedSearch in Google Scholar
  • 7 Jesus RC, Lopes MCH, Demarchi GTS, Ruiz CR, Wafae N, Wafae GC. The subscapular artery and the thoracodorsal branch: an anatomical study. Folia Morphol (Warsz) 2008; 67 (1) 58-62
    PubMedSearch in Google Scholar
  • 8 Lee JH, Kim DK. Bilateral variations in the origin and branches of the subscapular artery. Clin Anat 2008; 21 (8) 783-785
    CrossrefPubMedSearch in Google Scholar
  • 9 Olinger A, Benninger B. Branching patterns of the lateral thoracic, subscapular, and posterior circumflex humeral arteries and their relationship to the posterior cord of the brachial plexus. Clin Anat 2010; 23 (4) 407-412
    CrossrefPubMedSearch in Google Scholar
  • 10 Doi K, Muramatsu K, Hattori Y , et al. Restoration of prehension with the double free muscle technique following complete avulsion of the brachial plexus. Indications and long-term results. J Bone Joint Surg Am 2000; 82 (5) 652-666
    CrossrefPubMedSearch in Google Scholar
  • 11 Hattori Y, Doi K, Ikeda K, Watanabe M. Restoration of prehension using double free muscle technique following complete avulsion of brachial plexus in children. J Hand Surg 2005; 30A: 812-819
    PubMedSearch in Google Scholar
  • 12 Kompatscher P, Manestar M, Schuster A, Lang A, Beer GM. The thoracoacromial vessels as recipient vessels in microsurgery and supermicrosurgery: an anatomical and sonographic study. Plast Reconstr Surg 2005; 115 (1) 77-83
    PubMedSearch in Google Scholar
  • 13 Satoh T, Kimata Y, Hasegawa K, Namba Y. The utility of multidetector-row computed tomography angiography for evaluating perforators of fibular osteocutaneous flaps. J Reconstr Microsurg 2011; 27 (1) 29-36
    Thieme ConnectPubMedSearch in Google Scholar
  • 14 Ono S, Chung KC, Hayashi H, Ogawa R, Takami Y, Hyakusoku H. Application of multidetector-row computed tomography in propeller flap planning. Plast Reconstr Surg 2011; 127 (2) 703-711
    CrossrefPubMedSearch in Google Scholar
  • 15 Tan O, Yuce I, Kantarci M, Algan S. Evaluation of lower-limb arteries with multidetector computed tomography angiography prior to free flap surgery: a radioanatomic study. J Reconstr Microsurg 2011; 27 (3) 199-206
    Thieme ConnectPubMedSearch in Google Scholar
  • 16 Fan Z, Hodnett PA, Davarpanah AH , et al. Noncontrast MR angiography of the hand: Improved arterial conspicuity by multi-directional flow-sensitive dephasing magnetization preparation in 3D balanced SSEP imaging. Invest Radiol 2011; 46: 515-523
    CrossrefPubMedSearch in Google Scholar
  • 17 Steger-Hartmann T, Hofmeister R, Ernst R, Pietsch H, Sieber MA, Walter J. A review of preclinical safety data for magnevist (gadopentetate dimeglumine) in the context of nephrogenic systemic fibrosis. Invest Radiol 2010; 45 (9) 520-528
    CrossrefPubMedSearch in Google Scholar