Variations in branching pattern of the axillary artery: a study in 40 human cadavers

BACKGROUND: Variations in the branching pattern of the axillary artery are a rule rather than an exception. The knowledge of these variations is of anatomical, radiological, and surgical interest to explain unexpected clinical signs and symptoms. OBJECTIVE: The large percentage of variations in branching pattern of axillary artery is making it worthwhile to take any anomaly into consideration. The type and frequency of these vascular variations should be well understood and documented, as increasing performance of coronary artery bypass surgery and other cardiovascular surgical procedures. The objective of this study is to observe variations in axillary artery branches in human cadavers. METHODS: We dissected 80 limbs of 40 human adult embalmed cadavers of Asian origin and we have studied the branching patterns of the axillary artery. RESULTS: We found variations in branching pattern of axillary artery in 62.5% of the limbs. Anatomical variations included: origin of lateral thoracic artery from the subscapular artery; absent thoracoacromial trunk and all its branches arose directly from the second part of the axillary artery; division of thoracoacromial trunk into deltoacromial and clavipectoral trunks, which were divided into all branches of thoracoacromial trunk; origin of subscapular, anterior circumflex humeral, posterior circumflex humeral and profunda brachii arteries from a common trunk from the third part of the axillary artery; and origin of posterior circumflex humeral artery from brachial artery in addition to third part of the axillary artery. CONCLUSIONS: The study was carried out to show important variations in the branching pattern of axillary artery, in order to orient the surgeons performing angiography, coronary bypass, and flaps in reconstructive surgeries.

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Variations in the Axillary Artery Branching Pattern

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/44533.13887 ◽

2020 ◽

Author(s):

Deepshikha Singh ◽

Minakshi Malhotra ◽

Sneh Agarwal

Keyword(s):

Axillary Artery ◽

Ulnar Artery ◽

Point Of View ◽

Common Trunk ◽

New Delhi ◽

Branching Pattern ◽

Medical College ◽

Lateral Thoracic Artery ◽

Pectoral Nerve ◽

The Right

Variations in axillary artery branching pattern can lead to iatrogenic injuries during invasive procedures. Knowledge of the same is critical to prevent such events. Multiple bilateral variations were observed in the branching pattern of axillary artery. These variations were noted in a female cadaver, during routine undergraduate dissection in September 2019 in Lady Hardinge Medical College, New Delhi. On the left side, an anomalous branch running with the medial pectoral nerve was found. A common stem arising from the 2nd part of left axillary artery divided to give the lateral thoracic artery, the subscapular artery and an alar artery. Another alar branch arose from the left subscapular artery before it bifurcated into thoraco-dorsal and circumflex scapular arteries. The right axillary artery gave an aberrant branch proximal to the lateral thoracic artery. A common trunk arising from the 2nd part of right axillary branched out to give the posterior circumflex humeral artery, the subscapular artery and an alar artery. The brachial artery divided 13.5 cm proximal to the intercondylar line of humerus on the left and 14.4 cm on the right side. On both sides, the ulnar artery arose proximally and the radial and common inter-osseous arteries continued as a common trunk and divided distally. This case study reports multiple bilateral axillary artery anomalies and complements to the existing knowledge of vascular anomalies. Comprehensive knowledge of these variations is essential from anatomical, radiological and surgical point of view. During surgeries involving axillary and pectoral group of lymph nodes, such variations should be kept in mind.

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Topography and Anatomical Variations of the Axillary Artery

BioMed Research International ◽

10.1155/2021/6393780 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Kiwook Yang ◽

Hyunsu Lee ◽

In-Jang Choi ◽

Woonhyeok Jeong ◽

Hong-Tae Kim ◽

...

Keyword(s):

Axillary Artery ◽

Average Length ◽

Anatomical Variations ◽

Common Origin ◽

Reference Line ◽

Common Trunk ◽

Branching Pattern ◽

Upper Limbs ◽

Adult Human ◽

Number Of Branches

Knowledge of anatomical variations of the limb’s main arteries is significant for the clinicians. Thus, this study is aimed at examining the branching pattern and anatomical variations of the axillary artery. We conducted research on 59 upper limbs of adult human donated cadavers. All axillary artery branches’ origins were assessed, and the correlations between points of origins and variations of specific branches were evaluated. The average length of the axillary artery was found to be 11.22 cm, and this length was defined as reference line. Based on this reference line, the first, second, and third parts were 37.56%, 39%, and 30.05%, respectively. The STA was originated from 25.11%. The TAA and LTA were 42.67% and 54.82%, respectively. The SSA, ACHA, and PCHA were 64.72%, 83.89%, and 84.53%, respectively. The origin of LTA was correlated with that of SSA ( R = 0.473 , P < 0.05 ) and AHCA ( R = 0.307 , P < 0.05 ), respectively. And there was a positive correlation between AHCA and PHCA ( R = 0.705 , P < 0.05 ). The number of branches ranged from 3~6, and 9 types were shown. The most frequent branching pattern was common origin of the LTA and SSA (22/59). And AHCA and PHCA were originated together in 19 cases, and both patterns were combined in 12 cases. TTA and LTA branched together in 9 cases, and common trunk for the SSA, PHCA, and AHCA was found in 2 cases. According to this pattern, the origin of LTA and PCHA was significantly different. This information is particularly useful for surgeons and clinicians.

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Unilateral variation in branching pattern of Right Axillary Artery - A Case Report

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v3i3.12905 ◽

2018 ◽

Vol 3 (3) ◽

Author(s):

B. Muraleedhar ◽

Chandrasekar Kuppi

Keyword(s):

Case Report ◽

Medical Students ◽

Axillary Artery ◽

Common Trunk ◽

Branching Pattern ◽

Medical College ◽

Thoracoacromial Artery ◽

Lateral Thoracic Artery ◽

Male Cadaver ◽

Posterior Circumflex Humeral Artery

The Axillary artery is the continuation of the subclavian artery and is a major artery of the upper limb. During the routine dissection for Undergraduate Ayurvedic Medical Students of Sharada Ayurvedic Medical College, Yadgir, Karnataka, India, in the Department of Anatomy, we come across a variation in branching pattern of second and third part of right axillary artery in male cadaver approximately 55 years of age. The first part of axillary artery was found to be normal. In the second part of axillary artery we observed two branches, first one is thoracoacromial artery arose as usual second branch given common trunk which is further divided into lateral thoracic artery and subscapular artery. Even third part of axillary artery gave one common trunk that terminated by bifurcating into Anterior Circumflex Humeral Artery and Posterior Circumflex Humeral Artery.

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BILATERAL VARIATION IN THE BRANCHING PATTERN OF THE AXILLARY ARTERY - A CASE REPORT

International Journal of Advanced Research ◽

10.21474/ijar01/12885 ◽

2021 ◽

Vol 9 (5) ◽

pp. 629-633

Author(s):

Hajira Fatima ◽

N. Hima Bindu ◽

Faiz Hussain Mohammad ◽

Dasari Chandipriya

Keyword(s):

Axillary Artery ◽

Diagnostic Procedures ◽

Common Trunk ◽

Branching Pattern ◽

The Third ◽

Clinical Procedures ◽

Lateral Thoracic Artery ◽

Thoracodorsal Artery ◽

Male Cadaver ◽

The Right

During routine dissection of a male cadaver for I year MBBS students in the department of Anatomy bilateral variations in the branching pattern of Axillary artery were observed. In the present study it was observed that, on the left side, the subscapular artery which usually arises from the third part of Axillary artery was found to be originating from the second part along with the lateral thoracic artery and thoraco-acromial artery whereas anterior circumflex humeral artery and posterior circumflex humeral artery originated from the third part as usual. On the right side, the circumflex scapular artery and the Thoracodorsal artery were arising as a common trunk from the third part which is not the usual pattern. Knowing such variations is of utmost significance in performing various clinical procedures by Vascular surgeons, Radiologists, Clinical anatomists and in interventional and diagnostic procedures in cardiovascular diseases.

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An Anatomical Variation of Terminal Branches of the Thoracoacromial Artery – Case Report

Journal of Interdisciplinary Medicine ◽

10.2478/jim-2020-0018 ◽

2020 ◽

Vol 5 (3) ◽

pp. 110-113

Author(s):

Loránd Kocsis ◽

Mihai-Iuliu Harșa ◽

Lóránd Dénes ◽

Zsuzsánna Pap

Keyword(s):

Axillary Artery ◽

Anatomical Variation ◽

Practical Importance ◽

Anatomical Variations ◽

Common Trunk ◽

Anatomical Variant ◽

Case Presentation ◽

Thoracoacromial Artery ◽

Lateral Thoracic Artery ◽

Shoulder Region

AbstractIntroduction: Mapping the branching patterns of the thoracoacromial artery has a particular practical importance. Familiarity with the different anatomical variations is essential for successful surgical procedures in the anterior shoulder region.Case presentation: We present an unusual anatomical variant observed during the dissection of a cadaver at the Department of Anatomy and Embryology of the “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Târgu Mureş, Romania. According to the classical description, the thoracoacromial artery originates from the second part of the axillary artery, but we observed an unusual branching variation: the thoracoacromial artery provided a subscapular branch right after its origin, then it split into a pectoral branch, the lateral thoracic artery, and a common trunk that gave a second pectoral branch and a deltoid-acromial branch. The clavicular branch was missing.Conclusions: The case we presented demonstrates that there are anatomical variations of the axillary artery system that are partially or entirely different from the classical descriptions. Our study describes a variation of the thoracoacromial artery that has not been reported so far.

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Upper limb arterial pattern: clinical correlation and embryological perspective

Jornal Vascular Brasileiro ◽

10.1590/1677-5449.210008 ◽

2021 ◽

Vol 20 ◽

Author(s):

Laishram Sophia ◽

Darshita Singh ◽

Neha Xalxo ◽

Anjoo Yadav ◽

Sneh Agarwal ◽

...

Keyword(s):

Upper Limb ◽

Brachial Artery ◽

Axillary Artery ◽

Common Trunk ◽

New Delhi ◽

Palmar Arch ◽

Medical College ◽

Human Cadavers ◽

Median Artery ◽

Development Methods

Abstract Background Variations in the upper limb arterial pattern are commonplace and necessitate complete familiarity for successful surgical and interventional procedures. Variance in the vascular tree may involve any part of the axis artery of the upper limb, including the axillary artery and brachial artery or its branches, in the form of radial and ulnar arteries, which eventually supply the hand via anastomosing arches. Objectives To study the peculiarities of the arterial pattern of the upper limb and to correlate them with embryological development. Methods The entire arterial branching of forty-two upper limbs of formalin fixed adult human cadavers was examined during routine dissection for educational purposes, conducted over a 3-year period in the Department of Anatomy, Lady Hardinge Medical College, New Delhi. Results The study found: 1) One case in which a common trunk arose from the third part of the axillary artery, which immediately splayed into four branches (2.4%); 2) High division of the brachial artery into ulnar and radial arteries, in 3 cases (7.1%); 3) Pentafurcation of the brachial artery into ulnar, interosseus, radial, and radial recurrent arteries and a muscular twig to the brachioradialis in 1/42 cases (2.4%); 4) Incomplete Superficial Palmar arch in 3/42 cases (7.1%); and 5) Presence of a median artery in 2/42 case(4.8%) Conclusions This study observed and described the varied arterial patterns of the upper limb and identified the various anomalous patterns, supplementing the surgeon’s armamentarium in various surgical procedures, thereby helping to prevent complications or failures of reconstructive surgeries, bypass angiography, and many similar procedures.

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A study on branching pattern of main portal vein

National Journal of Clinical Anatomy ◽

10.1055/s-0039-1700732 ◽

2017 ◽

Vol 06 (02) ◽

pp. 152-157

Author(s):

Chaitra BR ◽

Seema Deepak ◽

Dakshayani KR

Keyword(s):

Portal Vein ◽

Anatomical Variations ◽

Branching Pattern ◽

Main Portal Vein ◽

Human Cadavers ◽

Portal Vein Anatomy ◽

Left Portal Vein ◽

Clear Identification ◽

Intimate Knowledge ◽

Transplantation Procedures

Abstract Background: An intimate knowledge and awareness of branching patterns of main portal vein is necessary before hepatic surgeries. The presence of portal vein variants increases the risk of bile duct hilar anatomical variations also. This information may be of help for accurate radiological interpretation, to prevent complications like hemorrhage, difficult anastomosis in the recipient, ischemia in the graft and allograft failure at the time of liver transplantation. Hence the present study was conducted with the objective of observing the branching pattern of the main portal vein, to measure length of right portal vein and angle between right and left portal vein. Material and Methods: The present study was conducted on 84 liver specimens of human cadavers fixed with 5% formalin, collected from the Department of Anatomy and Forensic Medicine, MMC&RI, Mysore. The parameters were measured using image J software. Results: Bifurcation of main portal vein was seen in 75 liver specimens [89.3%]. Trifurcation of main portal vein was seen in 9 specimens [ 10.7%]. Mean angle between Right and left portal vein was 146.7°. Mean length of right portal vein was 2.27 cm. Conclusion: Knowledge of portal vein variations is critically significant in surgical resection and transplantation procedures. Resection of any portion of liver should be well planned and clear identification of sub segments of liver is necessary before surgery. Surgeons and radiologists must have a thorough understanding of variants in portal vein anatomy in order to prevent injury to portal vein and for successful radiological interventions.

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Variant Branching Pattern of Axillary Artery: A Case Report

Case Reports in Vascular Medicine ◽

10.1155/2012/976968 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 3

Author(s):

Swamy Ravindra Shantakumar ◽

K. G. Mohandas Rao

Keyword(s):

Case Report ◽

Cardiovascular Diseases ◽

Axillary Artery ◽

Diagnostic Procedures ◽

Common Trunk ◽

Branching Pattern ◽

Undergraduate Medical Students ◽

Medical College ◽

The Third ◽

Male Cadaver

During routine dissection of an approximately 50-year-old male cadaver for the undergraduate medical students at Melaka Manipal Medical College, Manipal University, Manipal, we came across a variation in branching pattern of right axillary artery. The second part of axillary artery gave rise to a common trunk which divided into the subscapular and lateral thoracic arteries. The third part of right axillary artery gave rise to anterior and posterior circumflex humeral arteries. Variations in the branching pattern of axillary artery are important for the surgeons performing interventional or diagnostic procedures in cardiovascular diseases.

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