Anatomical variations of the subscapular pedicle and its terminal branches: an anatomical study and a reappraisal in the light of current surgical approaches

Springer Science and Business Media LLC - Tập 41 - Trang 385-392 - 2018
Martin Lhuaire1,2,3, Mikael Hivelin1, Mohamed Derder1, Vincent Hunsinger1, Vincent Delmas4, Peter Abrahams5, Daniele Sommacale3, Reza Kianmanesh3, Christian Fontaine2, Laurent Lantieri1
1Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Université Paris Descartes, Paris V, Paris Cedex 15, France
2Institute of Anatomy and Organogenesis, Faculté de Médecine Henri Warembourg, Université de Lille II, Lille, France
3Department of General and Digestive Surgery, Hôpital Robert Debré, Centre Hospitalier Universitaire de Reims, Université de Reims Champagne-Ardenne, Reims, France
4Institute of Anatomy, URDIA, EA4465, UFR Biomédicale des Saints-Pères, Université Paris Descartes, Paris V, Paris, France
5Institute of Anatomy and Clinical Education, Warwick Medical School, University of Warwick, Coventry, UK

Tóm tắt

While anatomical variations of the subscapular vessels are frequently encountered during axillary dissection, little is found in the literature. The aim of this cadaveric study was to define arterial and venous anatomical variations and frequencies of the subscapular vascular pedicle and its terminal/afferent vessels in women. We performed 80 dissections of the axillary region on forty female formalin-embalmed cadavers. Each anatomical arrangement was photographed and recorded on a scheme before analysis. We propose a new classification of the subscapular pedicle variations. We observed three types of subscapular arterial variation. The type Ia was the most frequent arrangement (71% of our dissections), the type Ib was observed in 11% and the type II in 18% of cases. We observed four types of subscapular venous variation. The type Ia was observed in 63% of cases, the type Ib in 14%, the type II in 14% and the type III in 10% of cases. This knowledge of the anatomical variation arrangement and frequencies of the subscapular vascular pedicle will assist the surgeon when dissecting the axillary region for malignant or reconstructive procedures.

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