Smith Ricky, Mathangasinghe Yasith, Gonsalvez David
Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, Biomedical Discovery Institute, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia.
J Cardiothorac Surg. 2024 Dec 27;19(1):683. doi: 10.1186/s13019-024-03158-z.
Arterial variations in the upper limb are of significant clinical importance, especially in procedures such as venepunctures, coronary artery bypass grafts, trauma reconstructive surgeries, brachial plexus nerve blocks, and breast reconstructions. This report presents previously undocumented arterial variations in the upper limbs in a 95-year-old female cadaveric donor. We observed bilateral superficial ulnar arteries originating at the cubital fossa, deviating from the previously reported origin at the proximal brachial artery. We found additional variations in the branches of the axillary artery: on the right side, two superior thoracic arteries emerged from the first part of the axillary artery, an accessory branch supplied the subscapular muscle, and the large subscapular artery arising from the third part of the axillary artery gave rise to both the lateral thoracic and posterior circumflex humeral arteries. On the left side, a common trunk was identified, giving rise to the transverse cervical, dorsal scapular, and accessory lateral thoracic and subscapular arteries. Moreover, the acromial artery originated directly from the axillary artery on both sides. This case report discusses the clinical significance of these unique vascular anatomical variants, their prevalence, and potential impact, emphasizing the importance for clinicians to be aware of such variations to enhance surgical planning and patient safety.
上肢动脉变异具有重要的临床意义，尤其是在静脉穿刺、冠状动脉搭桥术、创伤重建手术、臂丛神经阻滞和乳房重建等手术中。本报告展示了一名95岁女性尸体供体上肢中以前未记录的动脉变异情况。我们观察到双侧尺侧浅动脉起源于肘窝，与先前报道的起源于肱动脉近端不同。我们还发现腋动脉分支存在其他变异：右侧，两条胸上动脉从腋动脉第一部分发出，一条副支供应肩胛下肌，起源于腋动脉第三部分的大肩胛下动脉发出胸外侧动脉和旋肱后动脉。左侧，发现一条总干，发出颈横动脉、肩胛背动脉、副胸外侧动脉和肩胛下动脉。此外，两侧的肩峰动脉均直接起源于腋动脉。本病例报告讨论了这些独特血管解剖变异的临床意义、发生率和潜在影响，强调临床医生了解此类变异对于加强手术规划和患者安全的重要性。
