Title: Rare Variation in Branching Pattern of the Axillary Artery: A Cadaveric Study

Authors: Berjina Farooq Naqshi, Adil Bashir Shah, Sulaiman Sath, Dr Sangeeta Gupta, Dr Sunanda Raina, Dr Nusrat Jabeen

 DOI:  http://dx.doi.org/10.18535/jmscr/v3i11.28

Abstract

Introduction: Variations in the course and the branching pattern of the axillary artery is not rare. Knowledge about the aberrations of the axillary artery is very important in the fields of radiology, surgery, anatomy and orthopaedics. These variations in the axillary artery should be kept in mind during surgeries in the axillary region and pectoral region.            

Material and Methods: The study was conducted in the Postgraduate Department of Anatomy, Government Medical College, Jammu. The dissection was carried out on an embalmed male cadaver. The dissection was done for routine educational purposes in the dissection hall. The branching pattern of the axillary artery along with its various branches was studied with keen observation.

Results: In the present study, an anomalous common thoraco humeral trunk arose on the right side from the second part of the axillary artery which branched into lateral thoracic, anterior and posterior circumflex humeral, subscapular and thoracodorsal vessels. On the left side there were no aberrations in the axillary artery.

Discussion: Any deviation from the normal course and branching pattern of the axillary artery are of importance for radiologists, anatomists, orthopaedicians and surgeons. These variations in the branching pattern are of help to the orthopaedic surgeons while attempting reduction of old dislocations especially when axillary artery is adhered to the capsule.

Keywords: Axillary artery, thoraco humeral trunk, variation, upper limb.

References

1.      Standring S. Pectoral girdle, shoulder region and axilla. Gray’s  Anatomy. 39th ed. London: Churchill Livingstone; 2005:842-5.

2.      Natsis K, Piagkou M, Panagiotopoulos NA andApostolidis S.  An unusual high bifurcation and variable branching of the axillary artery in a Greek male cadaver. Springer Plus; 2014:3; 1-5.

3.      Kanaka S, Eluru RT, Basha MA, Somasekhar R, Kanchanalatha G and Haniman KS. Frequency of variations in axillary artery branches and its surgical importance. International journal of Scientific Study; 2015:3(6); 1-4.

4.      Poynter CWM. Congenital anomalies of the arteries and veins of the human body with bibliography. University studies, University of Nebraska; 1920:22; 1-106.

5.      McCormack LJ, Cauldwell EW, Anson BJ. Brachial and antebrachial arterial patterns: A study of 750 extremeties. Surg Gynecol Obstet; 1953:96; 43-54.

6.      Huelke DF. Variation in the origins of the branches of the axillary artery. Anat Rec; 1959:35; 33-41.

7.      Ozan H, Simsek C, Onderoglu S, Kirici Y and Basar R. High division of the axillary artery: A rare case of superficial ulnar artery. Acta Anal (Basel); 1994:151; 68-70.

8.      Jurjus AR, De- Aruaujo RC and Bohn RC. Bilateral double axillary artery: embryological basis and clinical implications. Clin Anat; 1999:12; 135-40.

9.      Aizawa Y, Ohtsuka K and 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; 554-68.

10.  Cavdar S, Zeybek A and Bayramicli M. Rare variation of the axillary artery. Clin Anat; 2000:13; 66-8.

11.  Trotter M, Henderson SL, Gass H, Brua RS, Weisman S and Agress H. The origins of branches of the axillary artery in whites and American Negroes. Anat Rec; 1930:46; 133-7.

12.  Sato Y, Takeuchi R, Kawshima T and Takafugi T. On the arterial supply in the human pectoralis major muscle. Kaibogaku Zasshi;1976:51; 311.

13.  Karlsson S and Niechajev IA. Arterial anatomy of the upper extremity. Acta Radiol Diagn (Stockh); 1982:23; 115-21.

14.  Sato Y and Takafugi T. Abdominal part of axillary artery: Proposed term for the artery supplying the abdominal part of the musculus pectoralis major. Acta Anat (Basel); 1992:145; 220-8.

15.  Kogan I and Lewinson D. Variation in the branching of the axillary artery: A description of a rare case. Acta Anat (Basel); 1998:162; 238-40.

16.  DeGaris CF and Swartley WB. The axillary artery in White and Negro stocks. Am J Anat; 1928:41; 353-97.

17.  Hollinshead WH. Anatomy for surgeons in general surgery of the upper limb. The back and limbs. Volume 3. New York: Heber-Harper Book; 1985; 290-300.

18.  Hamilton WJ and Mossman HW. Cardiovascular system. In : Human Embryology. 4th Edition. Baltimore: Williams and Wilkins; 1972; 271-90.

19.  Wollard HH. The development of principal arterial stems in the forelimb of the pig. Contrib Embryol; 1922:14; 139-54.

20.  Sanioglu S, Sokullu O and Ozay B et al. Safety of unilateral antegrade cerebral perfusion at 22 degrees C systemic hypothermia. Heart Surg Forum; 2008:11; 184-7.

21.  Uglietta JP and Kadir S. Arteriographic study of variant arterial anatomy of the upper extremities. Cadiovasc Intervent Radiol; 1989:12; 145-8.

22.  Saeed M, Rufai AA, Elsayed SE and Sadiq MS. Variations in the subclavian axillary arterial system. Saudi Med J; 2002: 22; 206-12.

23.  Ramesh TR, Prakashchandra S and Suresh R. Abnormal branching pattern of the axillary artery and its clinical significance. Int J Morphol; 2008:26;389-92.

24.  Vijaya PS, Venkata RV, Satheesha N, Mohandas R, Sreenivasa RB and Narendra P. A rare variation in the branching pattern of the axillary artery. Indian J Plast Surg; 2006:39; 222-3.

25.  Daimi SR, Siddiqui AU and Wabale RN. Variations in the branching pattern of axillary artery with high origin of radial artery. Int J Anat Var; 2010:3;76-7.

26.  Pandey SK and Shukla VK. Anatomical variation in origin and course of thoracoacromial trunk and its branches. Nepal Med Coll J; 2004:6; 88-91.

27.  Patnaik WG. Anomalous course of radial artery and a variant of deep palmar arch- a case report. J Anat Soc India; 2000:49; 54-7.

28.  Adachi B. Das Arteriensystem der Japaner,Vol.I,part I. Kyoto: Maruzen: 1928; 234-7.

29.  Keen JA. A study of the arterial variations in the limbs with special reference to symmetry of vascular patterns. Am J Anat; 1961:108; 245-61.

30.  Yamada M. Significance of the superficial subscapular artery. Japan Medical J, Junior Ser;1967:60; 3-7.

Corresponding Author

Dr Adil Bashir Shah

M.S. Orthopaedics, GMC Srinagar

Email-adilshah111gmail.com