ABSTRACT
The change of arising site of branches from the axillary artery determines it's topographic relationship with the brachial plexus because of closeness between the artery and the plexus. Variation of the subscapular artery (SSA) should be concerned when it is used for the source artery of some flaps, especially focusing on the variation of branching pattern and site of origin and relationships with the brachial plexus. In some cases of absence of SSA, if the circumflex scapular and the thoracodorsal arteries arise from the variable portion of the axillary artery separately, they might change the relationships with the brachial plexus. This study was performed to clarify the relationships between the subscapular artery and the brachial plexus according to the variation of the origin of the SSA and its branch. Two hundred seventeen axillae from 110 Korean cadavers were used for this study. SSA was found in 87.1% of cases, while in 12.9%, the circumflex scapular and the thoracodorsal arteries arose from the axillary artery (AA) seperately. SSA arose most frequently from the third part of the AA (63.6%), and in 4/5 of these cases, it ran behind the radial and ulnar nerves. When it arose from the second part (18.9%) or from the first part (4.6%) of AA, it mostly ran over anterior to the medial cord or/and the ulnar nerve. In 41.9% of the cases, a posterior circumflex humeral artery made a common trunk with the SSA or came from the circumflex scapular artery. In 28.1% of the materials, the SSA made a common trunk with a lateral thoracic artery especially when it arose from the first or second part of AA. After running a mean distance of 2.2 cm from AA, SSA was divided into the circumflex scapular and the thoracodorsal arteies. The SSA gave off the branches to the subscapularis in 68.7% of the cases, and the branches to the serratus anterior in 76.0%.
Subject(s)
Arteries , Axilla , Axillary Artery , Brachial Plexus , Cadaver , Running , Thoracic Arteries , Ulnar NerveABSTRACT
OBJETIVO: Estudar a suplência vascular do sexto arco costal, através de injeção de corante no segmento da artéria axilar que nutre os músculos peitoral menor e serrátil anterior. MÉTODO: Realizada dissecção de retalho osteomuscular em 20 cadáveres frescos, 19 do sexo masculino e um do sexo feminino, com idade variando de 43 a 60 anos e peso entre 55 a 80kg, contendo os músculos peitoral menor na parte cranial e o serrátil anterior na parte caudal, além da sexta costela na parte distal. Com o retalho elevado e destacado do tórax, e as aderências osteomusculares intactas, foi injetado sob pressão um corante hidrossolúvel - látex azul - na artéria axilar até observar-se a coloração dos vasos periostais. O arco costal foi fotografado com os vasos periostais corados e descalcificado em solução de ácido nítrico a 5 por cento e diluído em formalina a 10 por cento para estudo histológico. RESULTADOS: Em todos os cadáveres dissecados encontramos positividade pelo corante nos vasos periostais, como comprovação histológica. CONCLUSÕES: A presença de corante nos vasos periostais demonstra que esta rota de fluxo sangüínea pode viabilizar um retalho osteomuscular para reconstrução de face e mandíbula.
BACKGROUND: Injecting some dye into the segment of the axilar artery which nourishes the minor pectoral and anterior serratus muscles we could evaluate the periostal circulation at the sixth costal arc. METHOD: We studied an osteomuscular flap in 20 fresh corpses, 19 of them males, with ages varying from 43 to 60 and weight between 55 and 80 Kg, with the minor pectoral muscle in the cranial portion and the anterior serratus in the caudal portion. With intact muscular adhesions, a water-soluble dye - blue latex - was injected into the axilar artery under pression until periostal vessel coloration could be seen. The costal arc was photographed with the dyed periosteous vessels and was decalcified in 5 percent nitric acid solution thinned in 10 percent formalin for histological study of the periosteous. RESULTS: In all of the dissected corpses positivity by the dye in periosteous vessels could be found and histologically proved. CONCLUSION: Blood fluid course throuh periosteous vessels can accomplish an osteomuscular flap on extensive reconstructions of face and mandible.